·胰岛素抵抗及其相关疾病·

　　【摘要】 目的 通过观察不同糖耐量人群HbA1c、胰岛β细胞第一时相分泌，初步探讨它们之间的相互关系。 方法 纳入新诊断T2DM患者(T2DM组)115例、糖调节受损患者(IGR组)110例及正常对照者(NGT组)122例，以葡萄糖刺激后3～5 min急性胰岛素反应(AIR3-5)来表示第一时相胰岛素分泌功能指数，测定HbA1c、血脂并进行比较。 结果 T2DM组HbA1c(9.62±2.71)%高于其它两组[IGR组(6.81±1.51)%，NGT组(4.11±0.64)%]，而AIR3-5(7.62±3.21)低于其它两组[IGR组(25.49±6.54)，NGT组(56.41±8.32)]，差异有统计学意义(P<0.05);IGR组HbA1c高于NGT组，而AIR3-5低于NGT组，差异有统计学意义(P<0.05);AIR3-5与HDL-C呈正相关,与HbA1c、TG、LDL-C、BMI呈负相关。 结论 从NGT、IGR到T2DM的发生发展过程中，AIR3-5水平逐渐降低，相应出现HbA1c升高。

　　【关键词】 糖尿病,2型;糖调节受损;糖化血红蛋白;急性胰岛素反应

The relation between glycosylated hemoglobin and the first-phase insulin secretion of β cells in normal and impaired glucose tolerance and T2DM subjects YANG Yan , DENG Hua-cong, LONG Jian, et al. Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University , Chongqing 400016, China

Corresponding author: DENG Hua-cong, E-mail: deng_huacong@yahoo.com.cn

　　【Abstract】Objective To investigate the relation between HbA1c and the first-phase insulin secretion of β cells of pancreas in individuals with different levels of glucose tolerance. Methods The subjects were divided into three groups:125 patients with newly diagnosed T2DM (T2DM group), 110 patients with impaired glucose regulation (IGR group), and 122 individuals with normal glucose tolerance (NGT group, as control). AIR3-5 reflected the first-phase insulin secretion function after the glucose loading. HbA1c, TC,TG, LDL-C, and HDL-C were determined for comparison. Results The level of HbA1c (9.62±2.71)% was higher in the T2DM group than that in the IGR and NGT groups [(IGR group 6.81±1.51% and NGT group 4.11±0.64%) (P<0.05)], while the level of AIR3-5 (7.62±3.21) was lower in the T2DM group than that in the IGR and NGT groups [(IGR group 25.49±6.54 and NGT group 56.41±8.32) (P<0.05)], and the differences were statistically significant. The level of HbA1c was higher and the level of AIR3-5 was lower in the IGR group than those in the NGT group (P<0.05). AIR3-5 was positively correlated with HDL-C, and negatively correlated with HbA1c, TG, LDL-C, and BMI. Conclusion During the course of disease from NGT to IGR to T2DM, AIR 3-5 is decreasing followed by plasma HbA1c increasing gradually. The level of HbA1c may be used as one of simple clinical indexes to evaluate the function of insulin secretion of β cells.

　　【Key words】Diabetes mellitus, type 2; Impaired glucose regulation; Glycosylated hemoglobin; Acute insulin response