摘要
目的评价高甘油三酯(甘油三酯≥2.3 mmol/L)、正常葡萄糖耐量人群的胰岛素分泌和胰岛素敏感性.方法筛选正常糖耐量的高甘油三酯血症患者12名(高甘油三酯组,HTG组)和性别、年龄、体重指数相匹配的正常糖耐量、正常血脂者12名(正常对照组,NC组),应用高葡萄糖钳夹技术评价胰岛β细胞功能及胰岛素敏感性. 结果 HTG组和NC组在钳夹过程中胰岛素呈双相分泌,第一时相胰岛素分泌均于4～6 min达到高峰,在10～30 min下降,之后随钳夹时间延长逐渐升高,稳态期(120～150 min)达到最高.HTG组第一时相胰岛素分泌水平低于NC组[(224.7±133.2) mIU/L vs (252.6±108.9 )mIU/L,P=0.58],但差别无统计学意义;第二时相胰岛素分泌[(98.6±37.7) mIU/L vs (65.2±20.0 ) mIU/L, P＜0.05]和最大胰岛素分泌率[(135.1±45.2) mIU/L vs (84.5±29.8) mIU/L,P＜0.01]均明显高于NC组,胰岛素敏感性指数则显著低于NC组[(9.89±4.05 vs 21.97±9.62,P＜0.01).结论正常糖耐量的高甘油三酯血症人群中已经出现明显胰岛素抵抗和代偿性胰岛素分泌增加,高葡萄糖钳夹试验中胰岛素分泌曲线异常.
Objective To investigate the insulin secretion and insulin sensitivity in individuals with hypertriglyceridemia. Methods Twelve subjects with hypertriglyceridemia (HTG, triglyceride≥2.3 mmol/L) and normal glucose tolerance were selected as HTG group, 12 subjects with both normal glucose tolerance and normal plasma triglyceride as normal control group(NC group). Age, sex, BMI were matched between two groups. Hyperglycemic clamp was applied to determine insulin secretion and insulin sensitivity. Results All subjects of both groups showed biphasic insulin release, the first peak of insulin secretion appeared in 4-6 minutes after injecting 20% glucose, then the insulin secretion returned to the lowest value during 10-30 minutes, and the insulin concentration increased slowly and reached a stable top level at 120-150 minutes after the lowest value. The 1st phase insulin secretion in HTG group was lower than that in control group, but without significant difference [(224.7±133.2) mIU/L vs (252.6±108.9) mIU/L, P=0.58]. The 2nd phase insulin secretion in HTG group was higher than that in normal group [(98.6±37.7)mIU/L vs (65.2±20.0) mIU/L, P<0.05]. The maximal insulin secretion during 120-150 minutes was higher in HTG group [(135.1±45.2) mIU/L vs (84.5±29.8)mIU/L,P<0.01]. The hyperglycemic clamp insulin sensitivity index (dividing the average glucose metabolic rate by INS 120-150 during 120-150 minutes) was significantly lower in HTG group than that in control group (9.89±4.05 vs 21.97±9.62, P<0.01). Conclusion Subjects with HTG and normal glucose tolerance appear to show significant insulin resistance compensated with elevated insulin secretion.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2005年第3期211-214,共4页
Chinese Journal of Endocrinology and Metabolism
