初诊肥胖与非肥胖2型糖尿病IR、AIR和OS变化

目的研究肥胖与非肥胖初诊2型糖尿病(2DM)病人胰岛素抵抗(IR)、急性期胰岛素分泌(AIR)及氧化应激(OS)的特点,以探讨初诊2DM病人中肥胖对IR、AIR和OS的影响。方法对正常对照组(A组)36例、单纯初诊2DM组(B组)38例、并肥胖的初诊2DM组(C组)60例病人施以精氨酸刺激试验并计算胰岛素抵抗指数(HOMA-IR)、真胰岛素增值(△TI),同时对三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)、空腹血糖(FBG)、丙二醛(MDA)等水平进行分析和比较。结果 B、C组TG、LDL-C、FBG显著高于A组(F=9.51~36.13,q=4.01~11.86,P<0.05)。A、C两组△TI显著高于B组(F=4.26,q=3.14、3.96,P<0.05)。A、B、C组HOMA-IR、MDA依次升高,差异有显著性(F=36.42、36.45,q=3.85~12.06,P<0.05)。C组HOMA-IR与MDA、TC、LDL-C水平呈正相关(r=0.240~0.553,P<0.05);△TI与FBG、TG水平呈负相关(r=-0.805-、0.700,P<0.05);MDA和FBG、TG、TC、LDL-C水平呈正相关(r=0.227~0.839,P<0.05)。结论初诊2DM病人存在IR和AIR异常及OS。与非肥胖2DM病人相比,肥胖2DM病人IR及OS程度更为严重,但胰岛β细胞AIR相对充分。

DIVERSIFICATION OF THE INSULIN RESISTANCE, ACUTE INSULIN RESPONSE AND OXIDATIVE STRESS IN NEWLY-DIAGNOSED OBESE AND NON-OBESE PATIENTS WITH TYPE 2 DIABETES

Objective To study insulin resistance(IR),acute insulin response(AIR) and oxidative stress(OS) in newly-diagnosed obese and non-obese patients with type 2 diabetes(2DM) for further exploring the effects of obesity on IR,AIR and OS of the disease. Methods A total of 134 subjects including 36 normal controls(group A),38 non-obese patients with 2DM(group B) and 60 obese patients with 2DM(C group C) ] underwent arginine stimulation test for calculating HOMA-IR and △TI.Triglyceride(TG),total cholesterin(TC),low density lipoprotein-cholesterol(LDL-C),high density lipoprotein-cholesterol(HDL-C),fasting blood glucose(FBG),malonaldehyde(MDA),the results were analyzed and compared among different groups.Results Compared with group A,TG,LDL-C and FBG were higher in groups B and C(F=9.51-36.13;q=4.01-11.86;P<0.05).Compared with group B,△TI was higher in groups A and C(F=4.26;q=3.14,3.96;P<0.05).The HOMA-IR and MDA in groups B and C were higher than that in group A,and they were the highest in group C(F=36.42,36.45;q=3.85-12.06;P<0.05).In group C,HOMA-IR was positively correlated with MDA,TC,and LDL-C(r=0.240-0.553,P<0.05) and △TI was negatively correlated with FBG and TG(r=-0.805,-0.700;P<0.05);MDA was positively correlated with FBG,TG,TC,and LDL-C(r=0.227-0.839,P<0.05). Conclusion IR,AIR and OS coexist in newly-diagnosed type 2 diabetes.Compared with non-obese subjects with 2DM,the obese patients with 2DM have more severe IR and OS,but higher AIR.