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目的:研究糖尿病早期筛查的意义,评估其胰岛素敏感性及分泌功能,同时预测其发生糖尿病及其相关并发症的转归情况,为临床早期干预提供指导。方法:通过对患者进行口服葡萄糖耐量试验(OGTT),计算其体质指数,同时行血脂检测,早期筛查糖尿病并评估其胰岛素敏感性。结果:糖耐量减低(IGT)组患者平均年龄低于糖尿病(DM)组(52.0±10.9vs65.1±14.3,P<0.05);与正常葡萄糖耐量(NGT)组患者相比,空腹血糖调节受损(IFG)组、IGT组患者及DM组患者胰岛素敏感性(ISI0,120)明显下降,胰岛素抵抗明显(NGT vs IFG:92.0±22.3vs69.1±22.0;NGT vs IGT:92.0±22.3vs64.7±13.1;NGT vs DM92.0±22.3vs28.5±8.2,P<0.05);IGT组患者较IFG组患者胰岛素敏感性下降更明显(IFG vs IGT69.1±22.0vs64.7±13.1,P<0.05);胰岛素生成指数(IGI)IGT组明显高于IFG组(IFG vs IGT:1.69±0.80vs1.90±1.20,P<0.05);与NGT组相比,IFG组及DM组胰岛素早期相分泌(EPIR)明显降低(NGT vs IFG1stPH:243.9±173.5vs124.2±110.2,2ndPH:99.2±33.5vs62.6±37.4;NGT vs DM1stPH:243.9±173.5vs136.7±123.2,2ndPH:99.2±33.5vs38.8±33.3,P<0.05);且IGT组高于IFG组(IFG vs IGT1stPH:124.2±110.2vs200.4±186.3,P<0.05)。结论:IFG患者与IGT患者可能存在不同的发病机制,部分患者在正常葡萄糖耐量(NGT)时已经存在β细胞功能受损,OGTT检查对于揭示胰岛分泌功能及胰岛素抵抗,早期筛查糖尿病具有重要的意义,从而对糖尿病早期诊断早期干预提供临床指导意义。
OBJECTIVE: To study the significance of early screening of diabetes to evaluate its insulin sensitivity and secretion function, predict the occurrence of diabetes and its related complications, and provide guidance for early clinical intervention. Methods: Oral glucose tolerance test (OGTT) was performed on patients to calculate their body mass index, meanwhile, blood lipid test was conducted to screen for diabetes early and assess their insulin sensitivity. Results: The mean age of patients with impaired glucose tolerance (IGT) group was lower than that of diabetic group (52.0 ± 10.9 vs 65.1 ± 14.3, P <0.05). Compared with patients with normal glucose tolerance (NGT), the patients with impaired glucose regulation In patients with IFG, IGT and DM, the insulin sensitivity (ISI0,120) was significantly lower and insulin resistance was significantly higher (NGT vs IFG: 92.0 ± 22.3 vs 69.1 ± 22.0; NGT vs IGT: 92.0 ± 22.3 vs64. 7 ± 13.1; NGT vs DM92.0 ± 22.3 vs28.5 ± 8.2, P <0.05). The insulin sensitivity in IGT group was significantly lower than that in IFG group (IFG vs IGT69.1 ± 22.0 vs64.7 ± 13.1, P <0.05). Compared with NGT group, the IGT group had significantly higher levels of insulin in the IGT group (IFG vs IGT: 1.69 ± 0.80 vs 1.90 ± 1.20, P <0.05) Secretion (EPIR) was significantly lower (NGT versus IFGlstPH: 243.9 + 173.5 vs. 124.2 + 110.2, 2ndPH: 99.2 + 33.5 vs. 62.6 + 37.4; NGT vs. DMlstPH: 243.9 + 173.5 vs. 136.7 + 123.2, 2ndPH: 99.2 + 33.5 vs 38 .8 ± 33.3, P <0.05), and the IGT group was higher than IFG group (IFG vs IGT1stPH: 124.2 ± 110.2 vs200.4 ± 186.3, P <0.05). CONCLUSIONS: There may be different pathogenesis in patients with IFG and IGT. Some patients already have impaired β-cell function during normal glucose tolerance (NGT). OGTT may be important for screening insulin secretion and insulin resistance in early screening of diabetes Meaning, and thus early diagnosis of diabetes early intervention to provide clinical guidance.