摘要
目的 探讨本地区单纯性肥胖青少年糖代谢与脂联素（APN）及细胞炎性因子的关系.方法 在本市中学体检过程中选择80名单纯性肥胖青少年（12～18岁）作为肥胖组,另选择体质量正常的健康少年20名作为对照组,采用2h口服糖耐量试验（1.75 g/kg体质量葡萄糖）,每0.5h测血糖、胰岛素和C肽,空腹血同时测定APN、高敏C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）.胰岛素抵抗用胰岛素抵抗指数来评价,β细胞功能用注射葡萄糖30 min前后的胰岛素和血糖变化来评价.结果 肥胖组中,11.25％存在糖耐量受损,3.75％患有2型糖尿病.糖耐量受损人群在糖负荷后胰岛素和C肽水平明显升高,而2型糖尿病青少年30 min胰岛素变化与血糖变化的比是下降的.胰岛素抵抗在糖耐量受损人群中是显著存在的.IGT 及T2DM组TPN水平显著低于对照组及NGT组,Hs-CRP、TNF-α水平相反.结论 在本地区单纯性肥胖青少年中,糖耐量受损高度流行,糖耐量受损人群有明显胰岛素抵抗,但β细胞功能未见明显受损,而2型糖尿病则与β细胞功能减退有关.APN在少年肥胖及糖尿病发病过程中具有保护作用,细胞炎性因子表达异常是肥胖和糖尿病的独立危险因素.
Objective To explore the relationship between impaired glucose tolerance and serum adiponectin, inflammatory eytokines in adolescents with simple obesity. Methods All sub- jects underwent a two-hour oral glucose tolerance test （1.75 mg of glucose per-kilogram of body weight）, and glucose, insulin, and C-peptide levels were measured. Insulin resistance was estimated by insulin resistance index（IR： FIN ~ FPG/22.5）, and beta-cell function was estimated by insulin sensitivity index（IS= 1/FIN FPG）. The ratio between the changes in the insulin level and the glucose level during the first 30 minutes after the ingestion of glucose was calculated （I30-I0/G30- G0）. Serum adiponectin, serum c-reactive protein （Hs-CRP）, and tumor necrosis factor-a（TNF-a） were detected. Results Impaired glucose tolerance was detected in 11.25 percent of the 50 adoles- cents （12 to 18 years of age） and silent type 2 diabetes was identified in 3.75 percent of the adoles- cents. Insulin and C-peptide levels were markedly elevated after the glucose tolerance test in subjects with impaired glucose tolerance but not in adolescents with diabetes, who had a reduced ratio of the 30-minute change in the insulin level to the 30-minute change in the glucose level. Insulin resistance was significant in people with impaired glucose tolerance. Serum adiponectin in IGT group and T2DM group were significantly lower than the control group and NGT group. In contrast, Hs-CRP and TNF-a were higher than the control group and NGT group. Conclusion Impaired glucose tolerance is highly prevalent among children and adolescents with obesity . Impaired oral glucose tolerance is associated with insulin resistance while beta-cell function is still relatively preserved. Overt type 2 diabetes is linked to beta-cell failure. Adiponeetin has a protective role in the patho- genesis of obesity and diabetes in adolescents. The abnormal expression of inflammatory cytokine is independent risk factor of obesity and diabetes.
出处
《实用临床医药杂志》
CAS
2013年第17期20-22,26,共4页
Journal of Clinical Medicine in Practice
