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Insulin resistance and dysfunction of islet β cell in Chinese with impaired glucose regulation

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF DIABETES
Issue:
2
DOI:
10.3321/j.issn:1006-6187.2005.02.004
Key Word:
糖调节受损;空腹血糖受损;糖耐量受损;胰岛素抵抗; Impaired glucose regulation;Impaired fasting glucose; Impaired glucose tolerance; Insulin resistance

Abstract: Objective To investigate insulin resistance (IR)and dysfunction of islet β cell in 277 Chinese with impaired glucose regulation(IGR). Methods 724 participants (256 males)in Qingdao were classified into four groups: normal glucose tolerance (NGT, n=447), impaired fasting glucose (IFG, n=142), impaired glucose tolerance (IGT, n=93), combined IFG and IGT (IFG+IGT, n=42). The levels of plasma glucose, lipids (TC, HDL-C, TG)and insulin were measured. HOMA-IR, HOMA-β and △I30/△G30 after OGTT were calculated. Multivariable logistic regression (MVLR)was used to analyze the factors related to IFG and IGT. Results The age, waist circumference, body mass index(BMI), and blood pressure were more elevated in the groups of IFG, IGT and IFG plus IGT than those in NGT. Age and TG were higher in IGT than in IFG. After adjusting age, sex, (systolic) blood pressure and BMI, IGR had significantly increased HOMA-IR. However, there was no difference in those among IFG, IGT, and IFG+IGT. HOMA-β decreased significantly in groups of IFG(4.53±0.06) and IFG+IGT (4.38±0.10)than that in groups of NGT(5.10±0.04)and IGT(5.11±0.07). Meanwhile, there was no difference in that between NGT and IGT. △I30/△G30 was lower in IGT(4.62±0.14) vs NGT, but was no difference among IFG(4.86±0.11), IFG+IGT(4.70±0.22) and NGT(4.99±0.11). Age, BMI, and IR were independent risk factors for IFG, and basic β cell function was protective factor for IFG. Age and BMI were independent risk factors, and early phase of insulin secretion was protective factor for IGT. Conclusion Both IR and insulin (secretion) deficiency (ISD)are present in IGR subjects. The IFG subjects have IR and ISD, but still maintain the early phase of insulin secretion. The IGT subjects have IR and defect of the early phase of insulin secretion, but still maintain basic β-cell function.

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