【摘要】：目的探討2型糖尿病(T2DM)和糖調(diào)節(jié)異常(IGR)患者胰島α、β細(xì)胞功能的變化。方法選取2014年4月-2016年4月在該院就診的T2DM和IGR患者120例。其中,T2DM患者68例(T2DM組),IGR患者52例(IGR組),同時(shí)選取健康體檢者40例作為對(duì)照組,觀察各組空腹?fàn)顟B(tài)下胰島素穩(wěn)態(tài)模型分泌指數(shù)(HOMA-β)、胰島素穩(wěn)態(tài)模型胰島素抵抗指數(shù)(HOMA-IR)水平。結(jié)果 T2DM組血糖、胰高血糖素和游離脂肪酸分別為(8.70±0.73)mmol/L、(210.11±40.14)nmol/L和(0.89±0.21)mmol/L,與IGR組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),T2DM組高于IGR組;T2DM組胰島素水平與對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);IGR組胰島素水平與對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);T2DM組HOMA-IR為0.83(0.42,1.10),與IGR組、對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);而HOMA-β為(3.61±0.72),與對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);各組空腹胰高血糖素與HOMA-IR水平呈正相關(guān)(P0.05),與HOMA-β呈負(fù)相關(guān)(P0.05);T2DM組和IGR組空腹胰高血糖素與游離脂肪酸呈正相關(guān)(P0.05);口服葡萄糖耐量試驗(yàn)30、60、90和120 min時(shí)T2DM組胰島素水平與IGR組、對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),IGR組與對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);口服葡萄糖耐量試驗(yàn)30、60、90和120 min時(shí)T2DM組胰高血糖素水平與IGR組、對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05),IGR組與對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 T2DM和IGR患者胰島α、β細(xì)胞分泌異常,其中胰高血糖素和游離脂肪酸水平升高,且與HOMA-IR和HOMA-β水平有相關(guān)性。
[Abstract]:Objective to investigate the changes of islet 偽 and 尾 cell function in patients with type 2 diabetes mellitus (T2DM) and abnormal glucose regulation (IGR). Methods from April 2014 to April 2016, 120 patients with T2DM and IGR were selected. Among them, 68 patients with T2DM (52 patients with), IGR in T2DM group (IGR group) and 40 healthy subjects as control group) were selected as control group to observe the secretion index of insulin homeostasis model (HOMA- 尾) in fasting state of each group. Insulin resistance index (HOMA-IR) level in insulin homeostasis model. Results the levels of blood glucose, glucagon and free fatty acid in T2DM group were (8.70 鹵0.73) mmol/L, (210.11 鹵40.14) nmol/L and (0.89 鹵0.21) mmol/L, respectively, which were significantly different from those in IGR group (P 0.05). T2DM group was higher than IGR group. There was significant difference in insulin level between T2DM group and control group (P 0.05). There was significant difference in insulin level between); IGR group and control group (P 0.05). The HOMA-IR of T2DM group was 0.83 (0.42, 1.10), which was significantly different from that of IGR group and control group (P 0.05), while that of HOMA- 尾 was (3.61 鹵0.72), which was significantly different from that of control group (P 0.05). Fasting glucagon was positively correlated with HOMA-IR level and negatively correlated with HOMA- 尾 in each group (P 0.05), while fasting glucagon was positively correlated with free fatty acid in T2DM group and IGR group (P 0.05). The insulin level of T2DM group was significantly different from that of IGR group and control group at oral glucose tolerance test 30, 60, 90 and 120 min (P 0.05). There was significant difference between), IGR group and control group (P 0.05). At 30, 60, 90 and 120 min of oral glucose tolerance test, the glucagon level in T2DM group was significantly higher than that in IGR group and control group (P 0.05). There was significant difference between), IGR group and control group (P 0.05). Conclusion the secretion of islet 偽 and 尾 cells in patients with T2DM and IGR is abnormal, and the levels of glucagon and free fatty acids are increased, which are correlated with the levels of HOMA-IR and HOMA- 尾.
【作者單位】： 湖北省武漢市第八醫(yī)院內(nèi)科;武漢大學(xué)人民醫(yī)院內(nèi)分泌科;
【基金】：國家自然科學(xué)基金(No:81170767)
【分類號(hào)】：R587.1

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