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目的:探讨2型糖尿病(T2DM)家系非糖尿病一级亲属在不同糖耐量时胰岛素分泌第一时相的变化,及其在2型糖尿病发生、发展中的作用。方法:收集T2DM一级亲属正常糖耐量(NGT)组30例、糖耐量异常(IGT)组32例及新诊断T2DM组38例,并以无糖尿病家族史的30例健康成人(NC)为对照组,进行25 g静脉葡萄糖耐量试验(IVGTT),计算各组第一时相胰岛素分泌功能指数(AIR3-5)及胰岛素敏感指数(ISI)并进行比较。结果:新诊断的T2DM人群中,Homaβ、FPG、AIR3-5和ISI异常最为明显;而T2DM家系非糖尿病一级亲属的AIR3-5(53.67±2.36)mU/L和正常对照人群相比(80.85±1.43)mU/L出现下降;而ISI显著低于正常组均(P<0.01),但所有指标均处在正常人群和新诊断T2DM患者之间。结论:与正常对照人群相比,T2DM一级亲属NGT人群的胰岛β细胞第一时相胰岛素分泌减低,且存在胰岛素抵抗。
Objective: To investigate the changes of insulin secretion in first-degree relatives of non-diabetic first-degree relatives of type 2 diabetes (T2DM) families with different glucose tolerance and its role in the occurrence and development of type 2 diabetes mellitus. Methods: Thirty patients with normal glucose tolerance (NGT), 32 with IGT (IGT) and 38 with newly diagnosed T2DM were enrolled in the first-degree relatives of T2DM and 30 healthy adults without family history of diabetes (NC) (IVGTT). The first phase insulin secretion index (AIR3-5) and insulin sensitivity index (ISI) of each group were calculated and compared. Results: The abnormalities of Homaβ, FPG, AIR3-5 and ISI were the most significant among the newly diagnosed T2DM patients. Compared with the normal control subjects, AIR3-5 (53.67 ± 2.36) mU / L in non-diabetic first degree relatives of T2DM patients ± 1.43) mU / L, but ISI was significantly lower than the normal group (P <0.01), but all the indexes were between the normal population and newly diagnosed T2DM patients. CONCLUSION: Compared with normal controls, T2DM first-degree relatives of NGT population islet beta-cell first phase insulin secretion decreased, and there is insulin resistance.