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目的探讨2型糖尿病(T2DM)患者血清中游离脂肪酸(FFA)与血糖及胰岛素抵抗(IR)关系。方法选取本院2014年2月-2014年12月收治的68例T2DM患者。68例T2DM患者与68例健康正常人群组进行对照,行胰岛素释放实验以及口服葡萄糖的耐量试验(OGTT)。30 min后根据胰岛素与GLU浓度的变化来计算二者比值,随后计算胰岛素的敏感指数(ISI)。结果与健康对照组相比,T2DM患者FFAs、PFFA、TG浓度有所上升,其中ISI、FINs与GLU浓度的比值有所下降,组间比较差异有统计学意义(P<0.01);影响AUCG指标的主要因素为FFAs、ISI、AUCIN、TG以及胰岛素与GLU浓度的比值。结论 T2DM患者的空腹FFA、胰岛素的浓度得到升高的同时,高浓度的FFA水平会经由葡萄糖刺激胰岛素分泌功能受损,使得血糖浓度提高,且血清FFA水平能够从侧面反映IR的程度。
Objective To investigate the relationship between serum free fatty acid (FFA) and blood glucose and insulin resistance (IR) in type 2 diabetes mellitus (T2DM). Methods Sixty-eight T2DM patients were selected from February 2014 to December 2014 in our hospital. Sixty-eight patients with T2DM were compared with 68 healthy controls. The insulin release test and oral glucose tolerance test (OGTT) were performed. After 30 min, the ratio between insulin and GLU concentration was calculated to calculate the ratio of insulin sensitivity index (ISI). Results The concentrations of FFAs, PFFA and TG in T2DM patients were increased compared with those in healthy controls, and the ratios of ISI, FINs and GLU concentrations were decreased. The differences between the two groups were statistically significant (P <0.01) The main factors are FFAs, ISI, AUCIN, TG, and the ratio of insulin to GLU concentration. Conclusions Fasting plasma FFA and insulin concentrations are elevated in patients with T2DM, while high FFA levels are impaired by glucose stimulation of insulin secretion, resulting in elevated blood glucose levels and serum FFA levels reflecting the extent of IR from the side.