Analysis of Relationship between Body Mass Index and β-cell Function,Insulin Resistance in Elderly Type 2 Diabetic Mellitus_West China Medical Journal

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Geriatrics Department of Chengdu Military General Hospital, Chengdu Sichuan 610083,China;

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Keywords：

老年糖尿病; 肥胖; 胰岛素抵抗; β细胞功能

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目的:探讨老年2型糖尿病患者体重指数(BMI)与胰岛β功能状态及胰岛素抵抗(RI)的关系。方法:调查对象为2006年4月~2008年7月入我接受健康体检的成都地区离退休干部。采用1999年WHO糖尿病诊断标准,以129例已确诊T2DM患者为观察对象,根据体重指数(BMI)分为两组:肥胖组(含超重)(BMI≥25)66例,均为男性;非肥胖组(BMI lt;25)63例,其中3例为女性(无统计学意义),并与19例正常对照组进行对比研究。以氧化酶法测定空腹血葡萄糖(FBG),酶联免疫法测胰岛素(INS)及C肽(CP)水平等参数。用HOMA公式计算胰岛素抵抗(IR)和β细胞功能指数(BCI)。采用SPSS软件进行方差分析(ANOVA),分析3组间各指标的差异显著性x-±S表示。结果:三组经HOMA 公式计算的IR值为对照组(3.0±1.3)、非肥胖组(4.6±4.0)、肥胖组(5.2±6.2)依次递增,但各组间无显著性差异。HOMAβ细胞功能指数为非肥胖组(82.06±84.1)、肥胖组(138.4±179.6)、对照组(226.5±236.8)依次递增,各组间均有显著性差异(P lt;0.01～0.05)。结论:老年2型糖尿病患者普遍存在β细胞功能减退,尤其是非肥胖组;同时也具有胰岛素抵抗,主要是肥胖组。表明BMI对老年糖尿病患者胰岛β细胞功能有影响,肥胖患者β细胞分泌能力加强,负担加重,功能受损,胰岛素抵抗明显。

Citation： YE Xingrong,WANG Wei,SUN Haiqing,et al. Analysis of Relationship between Body Mass Index and β-cell Function,Insulin Resistance in Elderly Type 2 Diabetic Mellitus. West China Medical Journal, 2009, 24(4): 885-887. doi: Copy

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5.	MENEILLY CS, DAWSON K, TESSIER D. Alterations in glucose metabolism in the elderly patient with diabetes[J]. Diabetes Care,1993,16:1241-1248..
6.	SHIMIZU M, KAWAZU S, TOMONO S, et al. Age-related alteration of pancreatic β-cell function; Increased proinsulin and proinsulin-to-insulin molar ratio in elderly, but not in obese, subjects without glucose intolerance[J]. Diabetes Care,1996,19:8-11..
7.	MORLEY JE.An overview of diabetes mellitus in older persons[J]. Clin Geriatr Med,1999,15:211-224..
8.	王琼. 胰岛β细胞的休息与保护[J].护理研究 2005,9(19):1706-1708..
9.	孙丽明,鄢淑鑫,赵维,等.肥胖对老年糖尿病患者血清胰岛素及C肽释放水平的影响[J].中国实验诊断学, 2001,5:130-131.
10.	MORI Y,HOSHINO K,YOKOTA K,et al. Increased visceral fat and impaired glucose tolerance predict the increased risk of metabolic syndrome in Japanese middle-aged men [J]. Exp Clin Endocrinol Diabetes, 2005,113(6):334..
11.	刘军,查英,盛力,等. 腹型肥胖患者胰岛β细胞功能和胰岛素敏感性的变化[J].复旦学报,2006,33(3):396..

1. BERGMAN RN, FINEGOOD DT, KAHN SE. The evolution of beta-cell dysfunction and insulin resistance in type 2 diabetes[J]. Eur J Clin Invest, 2002,32(Suppl 3): 35-45..
2. 宁光. 2型糖尿病双重缺陷[J].国外医学内分泌学分册,2003,5(23):184-185..
3. PORTE JR D. Clinical importance of insulin secretion and its interaction with insulin resistance in the treatment of type 2 diabetes mellitus and its complications[J]. Diabetes Metab Res Rev,2001,17:181-188..
4. GAREIA GV, FREEMAN RV, SUPIANO MA,et al. Glucose metabolism in older adults; A study including subjects more than 80 years of age [J]. J Geriatr Soc,1997,45:813-817..
5. MENEILLY CS, DAWSON K, TESSIER D. Alterations in glucose metabolism in the elderly patient with diabetes[J]. Diabetes Care,1993,16:1241-1248..
6. SHIMIZU M, KAWAZU S, TOMONO S, et al. Age-related alteration of pancreatic β-cell function; Increased proinsulin and proinsulin-to-insulin molar ratio in elderly, but not in obese, subjects without glucose intolerance[J]. Diabetes Care,1996,19:8-11..
7. MORLEY JE.An overview of diabetes mellitus in older persons[J]. Clin Geriatr Med,1999,15:211-224..
8. 王琼. 胰岛β细胞的休息与保护[J].护理研究 2005,9(19):1706-1708..
9. 孙丽明,鄢淑鑫,赵维,等.肥胖对老年糖尿病患者血清胰岛素及C肽释放水平的影响[J].中国实验诊断学, 2001,5:130-131.
10. MORI Y,HOSHINO K,YOKOTA K,et al. Increased visceral fat and impaired glucose tolerance predict the increased risk of metabolic syndrome in Japanese middle-aged men [J]. Exp Clin Endocrinol Diabetes, 2005,113(6):334..
11. 刘军,查英,盛力,等. 腹型肥胖患者胰岛β细胞功能和胰岛素敏感性的变化[J].复旦学报,2006,33(3):396..

West China Medical Journal

Analysis of Relationship between Body Mass Index and β-cell Function,Insulin Resistance in Elderly Type 2 Diabetic Mellitus

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