2015年第75屆美國糖尿病協會(ADA)科學年會正在美國波士頓召開。由北京朝陽醫院內分泌科王廣教授團隊完成的一項研究在ADA2015年會最新研究壁報專場(Late Breaking Poster Session)上公布。該研究發現2型糖尿病的兩大病理生理機製——β細胞功能異常和胰島素抵抗在肥胖與非肥胖中國人群2型糖尿病進展中發揮著不同作用。以下是研究摘要譯文。
β細胞功能障礙在2型糖尿病的發病中起著重要作用,而肥胖是胰島素抵抗和2型糖尿病的主要原因。這項研究的目的是評估肥胖與非肥胖中國人從糖耐量正常到2型糖尿病的進展過程中,β細胞功能障礙和胰島素抵抗的不同作用。
共有3254名年齡≥25歲的受試者參與研究,包括1,843名健康對照和1411名新診斷的2型糖尿病患者。所有受試者被分為非肥胖對照、肥胖對照、非肥胖2型糖尿病和肥胖2型糖尿病患者。
無論是對照組或2型糖尿病組,肥胖受試者穩態模型評估的胰島素抵抗和β細胞功能(HOMA-IR和HOMA-β)均高於非肥胖者(P均<0.01)。
非肥胖2型糖尿病患者與非肥胖對照組患者相比,HOMA-IR較高,HOMA-β較低(P均<0.01)。
肥胖2型糖尿病患者的HOMA-β低於肥胖對照組患者(P<0.01),這兩組之間HOMA-IR沒有顯著差異。
結論:β細胞功能下降,再加上持續的胰島素抵抗,導致肥胖人群從糖耐量正常進展至2型糖尿病;而在非肥胖人群,胰島β細胞功能下降是促進糖尿病發生的主要因素。
【研究摘要】
Abstract Number: | 313-LB |
Title: | The Different Contributions of ß-Cell Dysfunction and Insulin Resistance to the Progression of Type 2 Diabetes in Obese and Nonobese Chinese People |
Authors: | JIA LIU, YING WANG, YANJIN HU, YUAN XU, SONG LENG, GUANG WANG, Beijing, China |
Abstract: | β-cell dysfunction plays a prominent role in type 2 diabetes (T2D) etiology, and obesity is a major cause of insulin resistance and T2D. This study aimed to assess the different roles of β-cell dysfunction and insulin resistance in the progression from normal glucose tolerance to T2D in obese and non-obese Chinese people. A total of 3254 participants aged ≥ 25 years, including 1,843 healthy controls and 1,411 newly diagnosed T2D patients were recruited. All participants were categorized into the non-obese control, obese control, non-obese T2D and obese T2D groups. The obese subjects had higher homeostasis model assessment of insulin resistance and β-cell function (HOMA-IR and HOMA-β) than the non-obese ones, whether in the control group or the T2D group (all P <0.01). Higher HOMA-IR and lower HOMA-β were observed in non-obese T2D patients when compared with non-obese controls (all P <0.01). The obese T2D group had lower HOMA-β than the obese control group (P< 0.01). There was no significant difference in HOMA-IR between the obese T2D and obese control groups. The decline of β-cell function, together with persistent insulin resistance, accounts for the progression from normal glucose tolerance to T2D in obese people, while the decline in β-cell function mainly contributes to the progression in non-obese people. |