【摘要】 目的探讨酮症起病糖尿病(KPD)患者BMI对胰岛素分泌和IS的影响。 方法将131例自发KPD患者根据BMl分为体重正常(Con)组、超重(Ow)组和肥胖(Ob)组。比较3组胰岛β细胞功能指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)等指标，并对其中50例进行随访，观察胰岛素功能的变化。 结果    与Con组随访患者比较，Ob组随访患者治疗后HOMA-β差值[8.28(-1.65，33.50)vs33.85(23.22，49.11)]升高，HOMA-IR差值[(0.84±1.62)vs(0.38±1.56)]降低(P<0.05)。单相关分析显示，HOMA-β与BMI呈正相关(r＝0.642，P<0.01)。校正IR、年龄、高血压、脂肪性肝病患病率、TG、TC、LDL-C等影响因素后，HOMA-β仍与BMI呈正相关(r＝0.278，P=0.022)。多元线性回归分析结果显示，治疗前lnHOMA-13与HbAl1c、BMI、lnHOMA-IR相关，治疗后与BMI相关。 结论BMI可作为简单可行的胰岛功能预测方法。
     【关键词】糖尿病，2型；肥胖；酮症；胰岛细胞功能；胰岛素抵抗
     【Abstract】 Objective To investigate the effect of BMI on insulin secretion and insulin sensitivity in newly diagnosed ketosis-onset diabetes． Methods   A total of 131 newly diagnosed ketosis-onset diabetic patients were enrolled in this study．All the subjects weredivided into three groups according to their BMI：normal weight group (Con)，over-weight group (Ow) and obese group (Ob)．Islet β-cell function (HOMA-β) and insulin resistance index (HOMA-IR) were compared among the groups．Fifty patients were followed up for the evaluation of changes of islet β-cell function． Results   HOMA-β was positively correlated with BMI (r＝0.642，P<0.01)．After adjustment for influencing factors such as
HOMA-IR，age，hypertension，fatty liverdisease morbidity，TG，TC and LDL-C，HOMA-β was still positively correlated with BMI (r＝0.278，P=0.022)．During follow up，changes of HOMA-β[33.85(23.22，49.11)vs 8.28 (-1.65，33.50)]and HOMA-IR [(0.84±1.62) vs (0.38±1.56)] were more significantin Ob group than in COn group after treatment(P<0.05)． Conclusion BMI can be used as a simple and feasible method for islet 13-cell function prediction．
     【Key words】Diabetes mellitus，type 2；Obesity；Ketosis；Islet cell function；Insulin resistance(IR)