血糖正常人群的胰岛素分泌及敏感性与2型糖尿病遗传背景遗传强度的相关性研究

发布时间：2018-02-26 14:48

本文关键词： 型糖尿病胰岛B细胞功能胰岛素敏感性　出处：《中国实用内科杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的评估上海居民糖代谢状况,观察2型糖尿病家族史人群不同遗传背景、遗传强度下的胰岛素分泌和胰岛素敏感性特点。方法对2016年12月至2017年2月上海多个社区血糖正常的居民进行流行病学调查问卷、体格检查以及口服葡萄糖耐量试验(OGTT),测定静脉血糖、胰岛素水平,根据稳态模型法(HOMA)及胰岛素敏感性指数(Gutt-ISI)评估胰岛素分泌及敏感性。结果 (1)292例上海市居民中2型糖尿病发生率为6.51%(19例)、空腹血糖受损(IFG)及糖耐量异常(IGT)发生率为12.67%(37例)。(2)2型糖尿病家族史阳性的男性及女性人群,其胰岛素敏感性较无家族史人群降低(HOMA-IS:男性0.52±0.17对0.54±0.28,女性0.59±0.30对0.69±0.33,P=0.04),胰岛B细胞分泌功能较无家族史人群升高显著(HOMA-β:男性190.6±130.31对142.58±76.06,女性157.84±96.68对120.87±74.71,P=0.02)。(3)在同胞2型糖尿病遗传背景人群的胰岛素敏感性及胰岛B细胞分泌功能较其他父系、母系、双系等遗传背景者改变具有统计学差异(P0.05),且胰岛素敏感性减退与糖尿病遗传背景呈负相关,HOMA-β水平呈正相关(P0.05)。结论有2型糖尿病家族史人群其在早期血糖正常时,即出现胰岛素敏感性下降,以同胞遗传背景为著,且胰岛素敏感性减退程度随遗传强度增加而递减,胰岛B细胞通过代偿性分泌以维持其血糖正常。
[Abstract]:Objective to evaluate the metabolic status of Shanghai residents, observe the family history of type 2 diabetes populations with different genetic backgrounds, genetic strength characteristics of insulin secretion and insulin sensitivity. Methods epidemiological on December 2016 to February 2017 in Shanghai a number of community residents with normal blood glucose questionnaire, physical examination and oral glucose tolerance test (OGTT), venous blood glucose determination and insulin levels, according to the steady-state model method (HOMA) and insulin sensitivity index (Gutt-ISI) assessment of insulin secretion and sensitivity. Results (1) of 292 patients with type 2 diabetes mellitus in Shanghai city the incidence rate was 6.51% (19 cases), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) incidence rate was 12.67% (37 cases). (2) the positive family history of type 2 diabetes mellitus of male and female groups, the insulin sensitivity was reduced without a family history of population (HOMA-IS: + 0.17 to 0.54 + 0.52 male 0.28, female 0.59 + 0.30 0.69 + 0.33, P=0.04), islet B cell secreting function with no family history of population increased significantly (HOMA- beta: male 190.6 + 130.31 to 142.58 + 76.06, 157.84 + 96.68 for women 120.87 + 74.71, P=0.02). (3) in the fellow genetic background of type 2 diabetes insulin sensitivity and secretion of islet B cells compared with other functional department of maternal, paternal, double genetic background changes have significant difference (P0.05), and insulin sensitivity decline was negatively correlated with the genetic background of diabetes, beta levels were positively related HOMA- (P0.05). Conclusion there is family history of type 2 diabetes population in the early stage of normal blood glucose, the insulin sensitivity decline, to compatriots genetic background, and insulin sensitivity decreased with the increase of the degree of genetic strength and decreased islet B cells through compensatory secretion to maintain normal blood glucose.

【作者单位】：第二军医大学附属长征医院内分泌科;
【基金】：上海市卫生与计划生育委员会公共卫生3年行动计划重点项目
【分类号】：R587.1

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