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目的探讨不同糖耐量人群,包括正常糖耐量(NGT)、空腹血糖受损(IFG)、糖耐量受损(IGT)、糖尿病人群血清脂联素、胰岛素抵抗及血管内皮功能变化及意义。方法从35～55岁健康体检人群中筛选出不伴有心脑血管疾病、血脂异常及其他系统性疾病者183例,其中IFG47例,IGT52例,糖尿病41例,NGT43例,检测血糖、胰岛素、血清脂联素及血管内皮功能等指标,并比较其空腹血糖、餐后2h血糖、胰岛素、胰岛素抵抗指数及血管内皮功能水平。结果空腹胰岛素在IFG[(12.10±1.66)mIU/L]、IGT[(10.95±1.30)mIU/L]、糖尿病[(13.10±4.63)mIU/L]3组间比较无统计学意义,但3组与NGT组[(8.22±2.10)mIU/L]比较均有统计学意义(P<0.05);餐后胰岛素在NGT组([33.14±1.88)mIU/L]与IGT组([46.87±2.96)mIU/L]、糖尿病组([49.65±3.32)mIU/L]比较均有统计学意义(P<0.05),IFG组[(43.36±2.01)mIU/L]与IGT组、IFG组与糖尿病组比较,差别有统计学意义(P<0.05),IFG、IGT、糖尿病组IR(分别为1.01±0.86,1.16±0.66,1.88±0.78)高于NGT组(0.60±0.48),差别有统计学意义(P<0.05),且糖尿病组IR高于IFG、IGT组,差别有统计学意义(P<0.05)。脂联素和血管内皮功能在NGT、IFG、IGT、糖尿病组依次降低,差别有统计学意义(P<0.05)。脂联素与FPG、HOMA-IR呈负相关(r=-0.04,-0.56,P<0.01),与内皮功能呈正相关(r=0.32,P<0.05)。血管内皮功能随脂联素水平逐步降低。结论IGT、IFG人群表现出胰岛素抵抗指数增加,脂联素水平下降,血管内皮功能下降,发展到糖尿病阶段后胰岛素抵抗、脂联素水平下降更明显。
Objective To investigate the changes and significance of serum glucose, adiponectin, insulin resistance and vascular endothelium in different population with impaired glucose tolerance, including normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) Methods A total of 183 patients without cardiovascular and cerebrovascular diseases, dyslipidemia and other systemic diseases were screened from 35- to 55-year-old healthy people. There were 47 cases of IFG, 52 cases of IGT, 41 cases of diabetes and 43 cases of NGT. Blood glucose, insulin, Serum adiponectin and vascular endothelial function and other indicators, and compared its fasting blood glucose, 2h postprandial blood glucose, insulin, insulin resistance index and vascular endothelial function levels. Results There was no significant difference in the fasting insulin between IFG group (12.10 ± 1.66 mIU / L) and IGT group (10.95 ± 1.30 mIU / L) and diabetes group (13.10 ± 4.63 mIU / L) (8.22 ± 2.10) mIU / L compared with NGT group (P <0.05). The postprandial insulin levels in NGT group (33.14 ± 1.88mIU / L) and IGT group (46.87 ± 2.96 (P <0.05). Compared with IGT group, IFG group and diabetes mellitus group ([(43.36 ± 2.01) mIU / L], diabetes group (49.65 ± 3.32 mIU / L) had statistical significance (P <0.05). The IR of IFG, IGT and diabetic group (1.01 ± 0.86,1.16 ± 0.66 and 1.88 ± 0.78, respectively) was higher than that of NGT group (0.60 ± 0.48), the difference was statistically significant (P <0.05), and the IR of diabetic group was higher than that of IFG and IGT group (P <0.05). Adiponectin and vascular endothelial function decreased in NGT, IFG, IGT and diabetic groups, with statistical significance (P <0.05). Adiponectin was negatively correlated with FPG and HOMA-IR (r = -0.04, -0.56, P <0.01), and positively correlated with endothelial function (r = 0.32, P <0.05). Vascular endothelial function gradually decreases with adiponectin level. Conclusions IGT and IFG patients showed an increase of insulin resistance index, adiponectin level and endothelial function. After the development of diabetes, insulin resistance and adiponectin level decreased more obviously.