长期危险饮酒对脂代谢及空腹血糖受损和糖耐量低减影响的研究

[摘要] 目的 探讨长期危险饮酒对正常人群空腹血糖受损(IFG)和糖耐量异常(IGT)发生率的影响，从而对长期危险饮酒人群T2DM的预防提供理论依据。方法 选出符合危险饮酒条件者106例为A组(酒龄在5年以上，均排除了T2DM)，年龄在30～55岁之间的男性，根据患者自愿的原则将A组分为禁酒组(A1组)53例和不禁酒组(A2组)53例；选择了62例不饮酒且IFG和IGT都正常者作对照组（B组）；分别抽取患者空腹和进食75g葡萄糖2 h的静脉血各5mL, 分离血清测定空腹血糖（FPG）、餐后2 h血糖（2hPG）、三酰甘油(TG)和总胆固醇(TC), 将余下的血清立即放置-20℃冰箱保存,集中在2个月内测定空腹胰岛素(FINS)和餐后2 h胰岛素(2hINS)。1年后以同样的方法对以上志愿者再次检测。 结果 A1组初与A2组初相比各指数之间均差异无显著性(P值均＞0.05)，非饮酒组(B组)与危险饮酒组(A组)相比各指数之间均差异有显著性 (P值均＜0.01)，IFG和IGT的发生率，A组显著高于B组（X 2值分别为8.75、8.21，P值均＜0.01）。一年后A1组与A2组相比，TC的P＜0.05, 有明显性差异外, 其他各指数之间的P值均＜0.01, 均有显著性差异，IFG和IGT的发生率，A1组显著低于A2组（X2值分别为9.28、8.69，P值均＜0.01）；A1组与B组相比，TC的P＜0.01差异有显著性，其他各指数之间的P值均＞0.05，均差异无显著性, A2组与B组相比，各指数之间的P值均＜0.01，均差异有显著性。结论 长期危险饮酒可使正常人的β细胞胰岛素分泌功能受损、组织细胞对胰岛素的敏感性下降并产生胰岛素抵抗，引发IFG和IGT。

Study on the relationship between long period of bibulosity with lipid metabolism and impaired fasting blood-glucose and impaired glucose tolerance

Abstract: Objective Actual medicinal study indicate that impaired fasting blood-glucose(IFG) and impaired glucose tolerance(IGT) are reversible middle phase of glycoregulation from natural persons transferring to type 2 diabetes mellitus(T2DM). The study is to explore the influence of long period of bibulosity on the incidence rate of IFG and IGT of natural persons to provide the gist of preventability for T2DM with long period of bibulosity. Methods Based on the bibulosity classification standard of WHO: male＞14 drink per week or once drinking＞4 drink, female＞7drink per week or once drinking＞3 drink (1 drink = 12g alcohol, equal 360ml beer or 180ml sherry or 45ml alcohol drink of 90 normal degrees). We chose 106 cases who had drunk for more than 5 years without T2DM into group A accorded with above standards from the hospital diabetes outpatients. They are male and the ages are 30 to 55 years old. Based on the free will of patients, we divided 53 cases into group A1 who did not drink alcohol and 53 cases into group A2 who were bibulosity, respectively. There were 62 cases who did not drink without IFG and IGT for collator (group B). We collected 5ml blood samples of limosis and having a meal of 75g glucose after 2h,separated serum immediately and measured fasting blood-glucose (FPG),2h postprandial plasma glucose (2hPG),triglyceride(TG)and total chol- esterol(TC), preserved spare serum under -20℃ immediately and measured the concentration of fasting insulin (FINS) and 2h postprandial insulin (2hINS) together in 2 months. They were measured with the same way 1 year later. Results There was not marked difference between the first index of A1 and A2 (P＞0.05) and all index of the group without drink (group B) was marked different from the group A (P＜0.01). The incidence rates of IFG and IGT of group A were obviously higher than group B. The values of X2 were 8.75 and 8.21 respectively (P＜0.01). Group A1 was compared with group A2 1 year later and we found that TC had marked difference (P＜0.05) and the other index had marked difference (P＜0.01). The incidence rates of IFG and IGT of group A1 were obviously lower than group A2. The values of X2 were 9.28 and 8.69 respectively (P＜0.01). Group A1 was compared with group B and we found that TC had marked difference (P＜0.01) and the other index did not have marked difference (P＞0.05). Group A2 was compared with group B and we found that all index had marked difference (P＜0.01). Conclusions Long period of bibulosity can suffer the function of natural B cell secreting insulin, but also it can depress the sensitivity of tissue to insulin and made insulin resistibility. Therefore, the impaired fasting blood-glucose and glucose tolerance(IFG、IGT)　were caused.