不同糖耐量人群血浆同型半胱氨酸水平与胰岛素抵抗及胰岛β细胞功能的关系

Relation between plasma homocysteine and insulin resistance and islet beta cell function in individuals with different glucose tolerance

  • 摘要: 目的: 观察不同糖耐量阶段血浆同型半胱氨酸(homocysteine,Hcy)水平,探讨Hcy与胰岛素抵抗和胰岛β细胞功能的关系。方法: 选择在我院健康查体的83名符合入选标准的个体,行标准口服75g葡萄糖耐量试验,留取空腹血标本测定血脂、肝肾功能、Hcy等指标,留取空腹、服糖后2h血标本测定血糖和胰岛素水平、尿微量白蛋白/肌酐水平。Hcy采用免疫荧光偏振法测定。结果: 经糖耐量试验将入选者分为糖耐量正常组(NGT)32例,糖耐量减低组(IGT)24例和新诊断糖尿病组(DM)27例。IGT组和DM组空腹Hcy水平明显高于NGT组(P<0.01)。IGT组和DM组HOMA-IR显著高于NGT组(P<0.01),IGT组和DM组ISI显著低于NGT组(P<0.01),NGT组和IGT组HBCI显著高于DM组(P<0.01,P<0.01),经HOMA-IR校正之后,NGT组HBCI/IR显著高于IGT组(P<0.01)。IGT组FBCI显著高于NGT组和DM组(P<0.05,P<0.01),经HOMA-IR校正之后,NGT组FBCI/IR显著高于IGT组和DM组(PPPr=-0.335,P=0.030)呈显著负相关,经HOMA-IR校正后,Hcy与HBCI/IR和FBCI/IR呈显著负相关性。多元逐步回归分析显示,腰围、尿Alb/Cr、FINS、HOMA-IR、FBCI和FBCI/IR对Hcy有显著影响。结论: 糖耐量受损者其血浆Hcy水平高于糖耐量正常者,胰岛素抵抗和胰岛β细胞功能受损与糖耐量异常者血浆Hcy水平明显相关。

     

    Abstract: Objective: To investigate the relation between plasma homocysteine(Hcy) and insulin resistance(IR) and islet beta cell function in individuals with different glucose tolerance. Methods: A total 83 subjects were recruited by oral glucose tolerance test(OGTT) in this study.Of these 83 subjects,32 had normal glucose tolerence(NGT),24 had impaired glucose tolerance(IGT) and 27 had newly diagnosed type 2 diabetes mellitus(DM).Levels of glucose and insulin were measured at fasting and 2h post-prandial.Plasma Hcy levels were measured by polarization immunoassay(FPIA). Results: Fasting plasma Hcy concentrations were significantly higher in IGT and DM groups in NGT group(P<0.01).Fasting plasma Hcy concentrations were higher in IGT group than in DM group,with no significant difference between the two groups(P>0.05).Fasting insulin levels were significantly higher in IGT group than in NGT and DM groups(P<0.01).HOMA-IR was lower in NGT group than in IGT and DM groups(P<0.01).The insulin sensitive index of NGT group was higher than that of DM group(P<0.01).HBCI,HBCI/IR and FBCI/IR were significantly higher in NGT group than in IGT and DM groups(P<0.01).HOMA-IR was positively correlated with plasma Hcy.ISI was negatively correlated with Hcy.HBCI/IR and FBCI/IR were negatively correlated with plasma Hcy. Conclusion: Concentration of Hcy is higher in patients with IGT and DM than in those with NGT.Beta cell function is more severely impaired in patients with IGT and DM than in those with NGT.

     

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