三酰甘油对糖耐量正常的2型糖尿病家系一级亲属代谢状况的影响研究

目的探讨三酰甘油(TG)水平对糖耐量正常的2型糖尿病(T2DM)家系一级亲属代谢状况的影响,从而为糖尿病高危人群的防治提供依据。方法将497例糖耐量正常的T2DM家系一级亲属,按照TG四分位数水平,将其分为4组:TG1组(TG<0.77 mmol/L)、TG2组(0.77≤TG<1.06 mmol/L)、TG3组(1.06≤TG<1.58mmol/L)和TG4组(TG≥1.58 mmol/L)。计算葡萄糖曲线下面积(AUC-G),采用稳态模型的胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗程度,采用稳态模型的胰岛素分泌指数(HOMA-β)和糖负荷后30 min胰岛素增值(△I30)与葡萄糖增值(△G30)的比值来评估胰岛β细胞功能。结果 TG4组受试者AUC-G、HOMA-IR和HO-MA-β均显著高于TG1组,差异有统计学意义(P<0.05)。从TG1组到TG3组,△I30/△G30逐渐增高,组间两两比较差异有统计学意义(P<0.05),而TG4组△I30/△G30出现下降趋势。多元逐步回归分析显示,TG、低密度脂蛋白(LDL)及△I30/△G30是影响血糖的主要因素(P<0.05)。结论随着TG水平增高,糖耐量正常的T2DM家系一级亲属胰岛素抵抗逐步加重,机体代偿性分泌胰岛素使血糖维持在正常范围,但最终出现胰岛早期分泌功能的下降。

Effects of Triglycerides on the Metabolism of First-degree Relatives of Type 2 Diabetes Mellitus Pedigree with Normal Glucose Tolerance

Objective To evaluate the effects of triglycerides on the metabolism of first-degree relatives of type 2 diabetes pedigree with normal glucose tolerance in order to provide evidence for the prevention and treatment of diabetes.Methods According to the level of serum triglyceride,497 first-degree relatives of type 2 diabetes pedigree with normal glucose tolerance were divided into four groups,including group TG1(TG<0.77 mmol/L),group TG2(0.77≤TG<1.06 mmol/L),group TG3(1.06≤TG<1.58 mmol/L) and group TG4(TG≥1.58 mmol/L).AUC-G was calculated and HOMA-IR was used to evaluate the degree of insulin resistance.HOMA-β and the value of △I30/△G30 were used to evaluate beta cell function.Results Compared with group TG1,the levels of AUC-G,HOMA-IR and HOMA-β in group TG4 were significantly higher(P<0.05).From group TG1 to group TG3,the value of △I30/△G30 gradually increased,and the differences were statistically significant pairwise(P<0.05).However,the value of △I30/△G30 in group TG4 decreased.Multiple stepwise regression analysis showed that TG,LDL and the value of △I30/△G30 were factors influencing blood glucose(P<0.05).Conclusion With the increase of the level of TG,the insulin resistance of first-degree relatives of type 2 diabetes pedigrees with normal insulin tolerance becomes more severe.The compensatory insulin secretion of the body can maintain the blood glucose at a normal level,but the early secretive function of pancreas islet will be damaged ultimately.