2型糖尿病患者胰岛素抵抗与血清游离脂肪酸浓度的关系

目的探讨2型糖尿病(T2DM)患者空腹与餐后2 h游离脂肪酸(FFA)浓度和胰岛素抵抗的关系。方法测定100例T2DM患者(根据亚洲糖尿病论坛的推荐分为控制良好和控制不良2组)及50名正常对照者的糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹FFA及餐后2 hFFA。以稳态模式评估胰岛素抵抗指数(HOMA-IR)。结果与对照组比较,T2DM组的FPG、2 h PG、FFA、2 h FFA、HbA1c、HOMA-IR均明显增高(P<0.01)。T2DM控制不良组各项指标均高于控制良好组(P<0.05),FFA、2 h FFA与HOMA-IR、HbA1c、FPG、2 h PG均呈明显的正相关(r分别为0.910、0.876,0.851、0.759,0.908、0.746,0.769、0.674,P<0.01)。结论 T2DM患者体内FFA浓度的增高与胰岛素抵抗存在明显相关性,与T2DM的发病机制有密切关系。

The relationship between insulin resistance and serum free fatty acid levels in patients with type 2 diabetes mellitus

Objective To investigate the relationship between the fasting levels and levels after diet for 2h of free fatty acid（FFA） and insulin resistance in patients with type 2 diabetes mellitus（T2DM）.Methods A total of 100 T2DM patients were enrolled and classified into good-control group and no-good-control group according to Asian Diabetes Forum,and 50 healthy controls were also enrolled.Their glycosylated hemoglobin（HbA1c）,fast insulin（FINS）,fast plasma glucose（FPG）,2 h plasma glucose（2 h PG）,fast FFA and 2 h FFA were determined.Homeostasis model assessment-insulin resistance index（HOMA-IR） was evaluated by HOMA.Results Compared with those in control group,FPG,2 h PG,FFA,2 h FFA,HbA1c and HOMA-IR increased significantly in T2DM group（P0.01）.The parameters in no-good-control group were higher than those in good-control group（P0.05）.FFA and 2 h FFA were positively correlated with HOMA-IR,HbA1c,FPG and 2 h PG（r=0.910 and 0.876,0.851 and 0.759,0.908 and 0.746 and 0.769 and 0.674,P0.01）.Conclusions The increasing of FFA levels is positively related with insulin resistance in T2DM patients,and may play an important role in the development of T2DM.