摘要
目的 研究胰岛素抵抗及胰岛素分泌功能在２型糖尿病（ＤＭ）发生、发展中的作用。方法 在２型ＤＭ家系成员中，对已诊断ＤＭ者按病程中位数分组，病程≤４年组１５３例，＞４年组１２９例。经口服葡萄糖耐量试验（ＯＧＴＴ），按１９９９年ＷＨＯ糖尿病诊断标准，新诊断ＤＭ组７２例。非ＤＭ者按ＨｂＡｌｃ分组，ＨｂＡｌｃ≤５．５％组７８例，ＨｂＡｌｃ＞５．５％组１１０例，计算各组ＨＯＭＡ模型胰岛素抵抗指数（ＨＯＭＡＩＲ）、β细胞功能指数（ＨＯＭＡβ）及胰岛素敏感性指数（ＩＳＩ），与无ＤＭ家族史的正常人９８例比较。结果除ＨｂＡｌｃ≤５．５％组外，家系各组ＨＯＭＡＩＲ均值高于正常对照，差异有显著性（Ｐ＜０．０１）。家系非ＤＭ两组ＨＯＭＡ β高于正常对照（Ｐ＜０．０１），ＤＭ各组ＨＯＭＡβ低于正常对照（Ｐ＜０．０１）。结论 北京地区２型ＤＭ家系中非ＤＭ一级亲属的胰岛素抵抗及糖耐量异常可能继发于胰岛素分泌功能异常增高，胰岛素分泌功能降低和胰岛素抵抗是发生糖尿病的主要机制。
Objective To investigate the roles of insulin resistance and insulin secretory function in the pathogenesis of type 2 diabetes mellitus (T2DM). Methods We recruited six groups of subjects. Individuas (n= 282) with previously diagnosed T2DM were selected from families included in our T2DM family study. They were divided according to the median duration of DM (4 years) into a group of 153 patients with duration 4 years or less and a group of 129 patients with duration more than 4 years. From the same families,we recruited 72 subjects with diabetes newly diagnosed by OGTT. Also from these same families,we recruited non-diabetic first-degree relatives (n=188) that we divided into the groups of 78 with HbAlc less than or equal 5. 5% and 110 with HbAlc over 5. 5%. In addition,we recruited 98 unrelated non-diabetic controls. In each group,we used the HOMA model to calculate HOMA-IR as an index of insulin resistance and HOMAβ as an index of beta-cell function. We also calculated the insulin sensitivity index (ISI). Results In all of the groups of subjects selected from the T2DM families,mean HOMA-IR was significantly (P＜0.01) higher than that in non-diabetic controls,with the exception of the group of non-diabetic relatives with HbAlc less than 5. 5%. In both groups of relative without diabetes,mean HOMA β was significantly (P＜0. 01 ) higher than that in normal controls,while in all 3 group of relatives with diabetes,mean HOMA β was significantly (P＜0. 01 ) lower than that of normal controls. In conclusion,in the families of patients with type 2 diabetes in the Beijing area,first degree relatives with normal glucose tolerance and low HbAlc have higher insulin secretion (HOMAβ) than nondiabetic controls,despite having a mean HOMA-IR comparable to the nondiabetic controls. Conclusion This evidence of over-active insulin secretory function in some non-diabetic relatives in T2DM families may point to a role of insulin secretion in the induction of insulin resistance and to the'development of glucose intolerance and T2DM. Diabetes occurs when insulin resistance worsens and insulin secretion declines.
出处
《中国糖尿病杂志》
CAS
CSCD
2001年第4期195-199,共5页
Chinese Journal of Diabetes
关键词
2型糖尿病
胰岛素抵抗
胰岛素分泌
家系
Diabetes mellitus, type 2 Insulin resistance insulin secretion Pedigree
