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肥胖儿童糖负荷后2小时血糖与胰岛β细胞功能和血脂关系的研究

王燕利1,刘戈力1,杨箐岩2,郑荣秀2,姜丽红3,李岩1,李亚璞2,鲍鹏丽2   

  1. 1. 天津医科大学总医院儿科
    2. 天津医科大学总医院
    3. 天津医大总医院儿科
  • 收稿日期:2012-08-07 修回日期:2012-10-23 出版日期:2013-02-15 发布日期:2013-02-15
  • 通讯作者: 王燕利

Study on the Relationship between levels of 2h-PG and changes of Islet β-cell function and Blood Lipid in Obese Children

  • Received:2012-08-07 Revised:2012-10-23 Published:2013-02-15 Online:2013-02-15
  • Contact: WANG Yan li

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摘要：

【摘要】目的 探讨肥胖儿童糖负荷后2 h血糖（2 h-PG）与胰岛β细胞功能和血脂的相关性。方法 收集9~15 岁肥胖儿童102例，空腹血糖（FPG）均<5.6 mmol/L，根据2 h-PG分为G1组（2 h-PG≤5.6mmol/L）、G2组（5.7~7.7 mmol/ L）和G3组（2 h-PG≥7.8 mmol/L）。比较各组之间糖脂代谢指标的差异及各指标与2 h-PG的相关关系。结果 G1组糖化血红蛋白（HAb1c）、FPG低于G2、G3组。G3组空腹胰岛素（FINS）、0.5 h胰岛素（0.5 h-INS）、胰岛素抵抗指数（HOMA-IR）高于G1、G2组。G3组高密度脂蛋白胆固醇（HDL-c）低于G1组。3组间0.5 h糖负荷后血糖（0.5 h-PG）、 2 h糖负荷后胰岛素（2 h-INS）、低密度脂蛋白胆固醇（LDL-c）、经胰岛素抵抗校正的早期胰岛素分泌指数（IR-EIS）差异均有统计学意义（P < 0.05或P ＜ 0.01）。扣除年龄和体质量指数（BMI）的影响，2 h-PG与HAb1c、FPG、0.5 h-PG、 0.5 h-INS、2 h-INS、HOMA-IR 、LDL-c呈正相关（P < 0.05或P ＜ 0.01），与IR-EIS呈负相关（P =0.002）。多重线性回归分析显示2 h-INS、FPG、FINS、IR-EIS是2 h-PG的影响因素。结论 肥胖儿童2 h-PG＞5.6 mmol/ L时已出现早期胰岛β细胞功能下降及血脂异常。

关键词: 肥胖儿童, 糖负荷后2h血糖, 胰岛β细胞功能, 胰岛素抵抗, 血脂

Abstract:

[Abstract] Objective  To investigate the relationship between the 2 h plasma glucose level after oral glucose tolerance tests (2h-PG) and islet β-cell function and blood lipid in obese children. Methods  A total of 102 obese children aged 9-15 years were enrolled in this trial. Levels of fasting plasma glucose (FPG) in children were all lower than 5.6 mmol/L. According to 2 h-PG, subjects were divided into G1 (2 h-PG≤5.6 mmol/L) group，G2 (5.7~7.7 mmol/L) group and G3 (2 h-PG ≥7.8 mmol /L) group．The parameters related to glucose and lipid metabolism were compared between groups. The relationship between 2 h-PG and all indexes were analyzed. Results  Levels of glycosylated hemoglobin（HbA1c) and FPG were significantly lower in G1 group than those in G2 group and G3 group. Levels of fasting insulin (FINS), 0.5 insulin (0.5 h-INS) and insulin resistance index (HOMA-IR) were significantly higher in G3 group than those in G1 and G2 groups. The level of high-density lipoprotein cholesterol（HDL-c）was significantly lower in G3 group than that in G1 group. There were significant differences in 0.5 plasma glucose after oral glucose tolerance tests (0.5 h-PG), 2-hour insulin after oral glucose tolerance tests（2h-INS), low density lipoprotein cholesterol (LDL-c) and early insulin secretion index corrected by insulin resistance (IR-EIS) between three groups (P < 0.05 or P < 0.01). The level of 2 h-PG was positively related with HAb1c，FPG， 0.5 h-PG，0.5 h-INS，2 h-INS，HOMA-IR and LDL-c (P < 0.05 or P < 0.01)，but 2 h-PG was negatively related with IR-EIS (P = 0.002) after deduction of the effects of age and BMI. Multiple linear regression analysis showed that 2h-INS， FPG，FINS and IR-EIS were influencing factors of 2 h-PG. Conclusion  When 2 h-PG is higher than 5.6 mmol/L in obese children，there has been early islet β-cell function decline and dyslipidemias.

Key words: obesity children, 2 h plasma glucose level after oral glucose tolerance test, Islet β-cell function, Insulin Resistence, lipid