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华西医学  2010 

血清游离脂肪酸与胰岛β细胞功能及胰岛素抵抗

, PP. 1255-1258

Keywords: 游离脂肪酸,指数,糖调节受损

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Abstract:

【】目的观察糖代谢异常不同阶段患者空腹及口服75g葡萄糖后血清游离脂肪酸(freefattyacid,FFA)的变化,探讨FFA随糖代谢异常进展的变化趋势及其与胰岛β细胞功能、胰岛素抵抗的关系。方法2003年5月-2005年4月对123例受试者通过口服葡萄糖耐量试验(OGTT)分为正常糖耐量组(NGT)20例,糖调节受损组(IGR)30例,初诊2型糖尿病组(NDM)41例,已诊2型糖尿病组(TDM)32例。测定其空腹及口服75g葡萄糖后的FFA、血糖、胰岛素及血脂的水平。结果①空腹FFA、OGTTFFA曲线下面积在IGR组、NDM组、TDM组均较NGT组明显增高,有统计学意义(P<0.05);各组OGTT2hFFA数值无差异,但随着2型糖尿病病情发展有逐渐增高的趋势。②空腹FFA、OGTT2hFFA与血糖、血脂均有相关性,且与胰岛β细胞功能有一定的负相关,OGTT2hFFA与胰岛素抵抗指数有一定的正相关。结论FFA对胰岛β细胞功能及胰岛素抵抗均有影响。【Abstract】ObjectiveToinvestigatethechangesoffreefattyacid(FFA)infastingstateand2hourslaterin75gglucoseabsorbedstate,andtherelationshipsbetweenFFAandpancreaticbeta-cellfunctionorinsulinresistance.MethodsFromMay2003toApril2005,123subjectsinpoliclinicweredividedintofourgroupsgroupAincluded20subjectswithnormalglucosetolerance(NGT),groupB30subjectswithimpairedglucoseregulation(IGR,includeIFGandIGT),groupC41newlyprovedtype2diabetesmellitus(DM2)subjects(NDM),andgroupD32drug-treatedDM2subjects(TDM).75gofglucosewasgiventoallsubjects.FastingFFAandFFA2hoursafteroralglucosetolerancetest(OGTT),seruminsulinlevels,plasmaglucoselevelsandfastingtriglycerol,cholesterol,high-densitylipoprotein,low-densitylipoproteinwereassessed.ResultsFastingFFAandtheareaunderthecurveofFFA(AUCFFA)inOGTTweresignificantlyhigherinIGRgroup,NDMgroupandTDMgroupthaninNGTgroup(P<0.05).SerumFFAlevels2hoursafterOGTTwerenotsignificantlydifferentamongfourgroups,buttheyincreasedwiththediseasedeveloping.FastingFFAandFFA2hoursafterOGTTcorrelatedwithplasmaglucoseandplasmalipid,andnegativelycorrelatedwithpancreaticbeta-cellfunctionindices.SerumFFA2hoursafterOGTTpositivelycorrelatedwithinsulinresistanceindices.ConclusionFFAinfluencesbothpancreaticbeta-cellfunctionandinsulinresistance.?

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