血清游离脂肪酸与胰岛β细胞功能及胰岛素抵抗

目的观察糖代谢异常不同阶段患者空腹及口服75g葡萄糖后血清游离脂肪酸（free fatty acid,FFA）的变化,探讨FFA随糖代谢异常进展的变化趋势及其与胰岛β细胞功能、胰岛素抵抗的关系。方法 2003年5月-2005年4月对123例受试者通过口服葡萄糖耐量试验（OGTT）分为正常糖耐量组（NGT）20例,糖调节受损组（IGR）30例,初诊2型糖尿病组（NDM）41例,已诊2型糖尿病组（TDM）32例。测定其空腹及口服75g葡萄糖后的FFA、血糖、胰岛素及血脂的水平。结果①空腹FFA、OGTTFFA曲线下面积在IGR组、NDM组、TDM组均较NGT组明显增高,有统计学意义（P〈0.05）;各组OGTT2hFFA数值无差异,但随着2型糖尿病病情发展有逐渐增高的趋势。②空腹FFA、OGTT2hFFA与血糖、血脂均有相关性,且与胰岛β细胞功能有一定的负相关,OGTT2hFFA与胰岛素抵抗指数有一定的正相关。结论 FFA对胰岛β细胞功能及胰岛素抵抗均有影响。

Relationships between Free Fatty Acids and Pancreatic Beta-cell Function or Insulin Resistance

Objective To investigate the changes of free fatty acid （FFA） in fasting state and 2 hours later in 75 g glucose absorbed state,and the relationships between FFA and pancreatic beta-cell function or insulin resistance.Methods From May 2003 to April 2005,123 subjects in policlinic were divided into four groups：group A included 20 subjects with normal glucose tolerance （NGT）,group B 30 subjects with impaired glucose regulation（IGR,include IFG and IGT）,group C 41 newly proved type 2 diabetes mellitus（DM2）subjects（NDM）,and group D 32 drug-treated DM2 subjects（TDM）.75 g of glucose was given to all subjects.Fasting FFA and FFA 2 hours after oral glucose tolerance test （ OGTT）,serum insulin levels,plasma glucose levels and fasting triglycerol,cholesterol,high-density lipoprotein,low-density lipoprotein were assessed.Results Fasting FFA and the area under the curve of FFA（AUCFFA）in OGTT were significantly higher in IGR group,NDM group and TDM group than in NGT group（P0.05）.Serum FFA levels 2 hours after OGTT were not significantly different among four groups,but they increased with the disease developing.Fasting FFA and FFA 2 hours after OGTT correlated with plasma glucose and plasma lipid,and negatively correlated with pancreatic beta-cell function indices.Serum FFA 2 hours after OGTT positively correlated with insulin resistance indices.Conclusion FFA influences both pancreatic beta-cell function and insulin resistance.