空腹血糖受损与糖耐量受损者胰岛素抵抗及胰岛B细胞功能的比较

目的比较空腹血糖受损（IFG）与糖耐量受损者（IGT）胰岛素抵抗及胰岛B细胞功能的不同。方法参照2003年ADA专家委员会建议标准，选择正常糖耐量者（NGT）51例，空腹血糖受损者30例，糖耐量受损者27例。测身高、体质量、血压、血脂及OGTT5点血糖值及胰岛素值。采用HOMA-IR评价IR，HBCI、△I30／△G30、MBCI分别评价基础状态下及糖负荷后的胰岛素分泌功能。结果校正年龄、性别、BMI后，IFG、IGT组HOMA-IR均明显高于NGT人群，差异有统计学意义（P〈0．05）；IGT组HOMA-IR与IFG组比较有下降，但差异无统计学意义。校正年龄等因素后，IFG组HBCI较IGT组降低，差异有统计学意义（P〈0．05）。IGT组MBCI较IFG组降低，差异有统计学意义（P〈0．05）。IGT组△I30／△G30与IFG组比较有下降，但差异无统计学意义。结论空腹血糖受损人群与糖耐量受损人群均存在明显胰岛素抵抗，空腹血糖受损人群主要表现为基础胰岛素分泌缺陷，而糖耐量受损人群为胰岛素早期分泌受损。

Study of the function of islet Bcell and insulin resistance in cases with impaired fasting glucose and impaired glucose tolerance

Objective To compare the difference of islet B cell function and insulin resistance between impaired fasting glucose and impaired glucose tolerance. Methods 51 patients with normal glucose tolerance, 30 with impaired fasting glucose and 27 with impaired glucose tolerance were measured their levels of body mass index, blood pressure, lipids,plasma glucose and insulin after OGTF. Insulin secretion and insulin resistance were evaluated and the following indexes were calculated： early insulin secretion index（ △I30/△G30 ） ; HOMA- B cell index（HBCI） of HOMA model; HOMA-IR; Dr. Li＇s new B-cell insulin secretion index（MBCI）. Results After age, sex and BMI adjustment, HOMA-IR in IFG and IGT group obviously increased （P 〈 0. 05 ）. However, there were no significant differences amongIFG and IGT groups. After age and other factors adjustment, HBCI in IFG group was evidently lower than that in IGT group （P 〈 0. 05 ）. MBCI was evidently lower in Groups of IGT than those in IFG group （P 〈 0. 05 ）. in IGT group was lower than that in IFG group, However, there were no significant differences among There w as no significant difference in △I30/△G30 between IFG and IGT groups. Conclusion IFG and IGT groups have significant IR. The individuals with IFG mainly showed defect of basic B cell function , the subjects with IGT showed defect of the early phase of insulin secretion.