·糖尿病肥胖、脂代谢异常·

　　【摘要】 目的 观察新诊断腹型肥胖T2DM患者胰岛α、β细胞的功能及控制血糖对其影响。 方法 148例新诊断T2DM患者分为腹型肥胖(AO)组和非腹型肥胖(NAO)组，控制血糖一周前、后，行100 g馒头餐试验，检测0、30、60、120、180 min各点血糖、C-P和胰升血糖素(Glu)。 结果 治疗前后，各时点血糖曲线下面积(AUCg)比较，差异无统计学意义(P>0.05);AO组治疗前和治疗后C-P曲线下面积(AUCC-P)均高于NAO组(P<0.01)，Glu曲线下面积(AUCGlu)治疗前高于NAO组[(609.34±167.26) vs (555.76±153.86) ng/L]，治疗后低于NAO组[(477.22±108.13) vs (518.12±129.48) ng/L](P<0.05)。治疗后，两组AUCC-P均升高，AUCg及AUCGlu均下降(P均<0.01)，AO组AUCGlu下降幅度大于NAO组。 结论 新诊断腹型肥胖T2DM患者存在胰岛α、β细胞功能异常，控制血糖能改善胰岛α、β细胞分泌紊乱，在腹型肥胖T2DM患者中尤为明显。

　　【关键词】 腹型肥胖;糖尿病，2型;胰升血糖素;C肽

　　【Abstract】Objective To evaluate effects of glycemic control on islet α and β cell function in newly diagnosed type 2 diabetics with abdominal obesity. Method A total of 148 newly diagnosed type 2 diabetics patients were divided into abdominal obese group (AO) and non-abdominal obese group (NAO). Steamed bread meal test was performed in all the participants at baseline and a week after glycemic control. Blood glucose(BG)，C-peptide(CP) and glucagon(Glu) were measured at different time points (0, 30, 60, 120 and 180 min) during steamed bread meal test. Results Areas under glucose curve (AUCg) had no significant differences between two groups at baseline or after treatment (P>0.05).But areas under C-peptide curve (AUCc-p) was higher in AO group than NAO in baseline and after treatment(P<0.01).Areas under glucagon curve (AUCGlU) were higher in AO group[(609.34±167.26)vs(555.76±153.86)ng/L] than in NAO before treatment, but lower[(477.22±108.13)vs(518.12±129.48)ng/L] than in NAO after treatment(P<0.05).Compared with baseline, AUCC-P increased while AUCBC and AUCGlu decreased in both groups(all P<0.01). Besides, the reduction of AUCGlu was larger in AO group than in NAO group. Conclusion The islet α and β cell dysfunction could be seen in newly diagnosed type 2 diabetes with abdominal obesity. The αand β islet cells function could be improved by glycemic control, especially in newly diagnosed type 2 diabetes with abdominal obesity.

　　【Key words】Abdominal obesity;Diabetes mellitus, type 2;glucagon;C-peptide