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目的:探讨以真胰岛素为指标观察胰岛素抵抗和胰岛B细胞功能的意义。方法:将35名有糖尿病家族史的正常糖耐量者(NGT)、31例糖耐量异常者(IGT)和62例新诊断的2型糖尿病患者分别按体重指数分为肥胖亚组与非肥胖亚组,以35名健康人作为对照组,采用微粒子化学发光法测定空腹血清真胰岛素,以稳态模型评估法评价胰岛素抵抗和胰岛B细胞功能。结果:在非肥胖亚组中,NGT、IGT、糖尿病组随空腹血糖的升高,胰岛素抵抗指数(HomaIR)逐渐高于正常,B细胞功能指数(HBCI)逐渐低于正常,而空腹真胰岛素与对照组比较无明显差异。肥胖亚组中,NGT组的空腹血糖虽然正常,但已有HomaIR升高,NGT和IGT组有HomaIR升高,但HBCI无异常,但此时的真胰岛素均已显示高于对照组且有统计学差异,P<0.01。结论:体重指数和血糖值均会影响HomaIR和HBCI,而真胰岛素的测定却能更真实地反映胰岛素抵抗及胰岛B细胞功能。
Objective: To investigate the significance of insulin resistance and islet B cell function using true insulin as an index. Methods: 35 normal glucose tolerance (NGT) patients, 31 IGT patients and 62 newly diagnosed type 2 diabetic patients with family history of diabetes were divided into obesity subgroup and non-obesity subgroup according to body mass index Group, 35 healthy volunteers were used as the control group. The fasting serum true insulin was determined by the method of microparticle chemiluminescence, and the insulin resistance and islet B cell function were evaluated by steady-state model assessment. Results: In the non-obese subgroup, NGT, IGT and diabetes increased with fasting blood glucose, HomaIR gradually higher than normal, B cell function index (HBCI) gradually lower than normal, fasting real insulin and There was no significant difference between the control group. In the obesity subgroup, although the fasting blood glucose in NGT group was normal, HomaIR had been increased, HomaIR increased in NGT and IGT group, but HBCI had no abnormality, but the true insulin in this group was higher than the control group Learning difference, P <0.01. CONCLUSION: BMI and blood glucose both affect HomaIR and HBCI, whereas true insulin is a more realistic indication of insulin resistance and islet B cell function.