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目的探讨不同血糖切点的空腹血糖调节受损(IFG)的老年人群的代谢、胰岛素抵抗及胰岛β细胞功能等方面的差异。方法空腹血糖(FPG)<7.0mmol/L的830名非糖尿病健康查体者,根据FPG水平分为3组:正常糖代谢组510例:FPG<5.6mmol/L;新增人群(IFG1)组167例:5.6mmol/L≤FPG<6.1mmol/L;原人群(IFG2)组153例:6.1mmol/L≤FPG<7.0mmol/L。测量血压、身高、体质量、腰围、臀围,计算体质量指数(BMI)、腰臀比(WHR),同时酶法测定甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、FPG及口服葡萄糖耐量试验(OGTT)2h血糖(2hPG);放射免疫法测空腹胰岛素(FINS)及OGTT2h胰岛素(PINS),计算稳态模型胰岛素抵抗指数(HOMA-IR)及B细胞功能指数(HOMA-B)。Logistic回归分析IFG1、IFG2发生餐后高血糖及代谢综合征(MS)的风险。结果与正常糖代谢组相比,IFG两组患者年龄、血压、BMI、WHR、TC、TG、LDL-C、FPG、2hPG和HOMA-IR均显著升高(P<0.05),而HDL-C与HOMA-B水平显著降低(P<0.05)。IFG2组的2hPG明显高于IFG1组(P<0.05)。与IFG1组相比,IFG2组HOMA-IR明显升高(P<0.05);HOMA-B水平有下降趋势但差异无统计学意义(P>0.05)。Logistic回归分析显示,与IFG1组相比,IFG2组发生餐后高血糖及MS的风险明显升高。结论老年IFG人群存在胰岛B细胞功能下降及胰岛素的抵抗,促进了糖尿病的发生发展;IFG2人群代谢紊乱与胰岛素抵抗更严重,与餐后高血糖及MS的关系更为密切。
Objective To investigate the differences in metabolism, insulin resistance and islet β-cell function in elderly people with impaired fasting glucose regulation (IFG) at different blood glucose sites. Methods 830 non-diabetic healthy volunteers with fasting plasma glucose (FPG) <7.0 mmol / L were divided into 3 groups according to the level of FPG: 510 cases of normal glucose metabolism group: FPG <5.6 mmol / L; 167 cases: 5.6mmol / L≤FPG <6.1mmol / L; 153 cases of original population (IFG2): 6.1mmol / L≤FPG <7.0mmol / L. Blood pressure, height, body weight, waist circumference and hip circumference were measured. Body mass index (BMI) and waist-hip ratio (WHR) were calculated. Simultaneously, triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), FPG and oral glucose tolerance test (OGTT) 2h blood glucose (2hPG); FINS and PINS were measured by radioimmunoassay Insulin resistance index (HOMA-IR) and B cell function index (HOMA-B). Logistic regression analysis of IFG1, IFG2 postprandial hyperglycemia and metabolic syndrome (MS) risk. Results Compared with the normal glucose metabolism group, the age, blood pressure, BMI, WHR, TC, TG, LDL-C, FPG, 2hPG and HOMA-IR of the IFG patients were significantly increased (P < And HOMA-B levels were significantly lower (P <0.05). 2hPG in IFG2 group was significantly higher than that in IFG1 group (P <0.05). Compared with IFG1 group, HOMA-IR in IFG2 group was significantly increased (P <0.05); HOMA-B level showed a downward trend but no significant difference (P> 0.05). Logistic regression analysis showed that the risk of postprandial hyperglycemia and MS in IFG2 group was significantly higher than that in IFG1 group. CONCLUSIONS: The decline of islet B cell function and insulin resistance in elderly IFG population promote the occurrence and development of diabetes. The metabolic disorder and insulin resistance are more serious in IFG2 population, which is more closely related to postprandial hyperglycemia and MS.