动静态指标在评价胰岛_细胞功能和胰岛素敏感性上差异.pdfVIP

CME CLINICAL PRACTICE/CME 临床实践 动静态指标在评价胰岛β细胞功能和胰岛素 敏感性上的差异 刘岩 郭青青 张宇翔 何燕▲ （首都医科大学公共卫生与家庭医学学院 100069） LIU Yan GUO Qing-qing ZHANG Yu-xiang HE Yan 【摘要】目的：试探讨静态指标与动态指标在评价胰岛β细胞功能和胰岛素敏感性上的差异。方法：对77例非糖尿病个体实施口服糖 耐量试验（OGTT），由此计算出OGTT测量参数及胰岛β细胞功能和胰岛素敏感性评价指标，分析动、静态指标在评价胰岛β细胞功 能和胰岛素敏感上的相关程度，并比较动、静态指标与OGTT测量参数关联程度上的差异。结果：动、静态指标在评价胰岛β细胞功 能和胰岛素敏感性上均有关联（P ＜0.001）；动态指标与OGTT各测量参数之间均有关联（P ＜0.05）；而静态指标中：稳态模型评估 胰岛细胞分泌指数（HOMA-B）与血糖含量曲线下面积（AUCgly）无关联（r ＝－0.198，P ＝0.116)，胰岛素敏感性指数（IAI）与血 浆胰岛素含量曲线下面积（AUCins）无关联（r ＝－0.216，P ＝0.088）。结论：对于要求准确评价人体糖负荷状态下胰岛β细胞功能 和胰岛素敏感性时，建议使用动态评价指标。 【关键词】口服糖耐量试验；胰岛β细胞功能；胰岛素敏感性；相关性 【Abstract】Objective: To detect the differences between basic indices and glucose load indices in evaluating pancreatic B-cell function and insulin sensitivity. Methods: 77 non-diabetic subjects underwent oral glucose tolerance test (OGTT) allowing for the calculation of OGTT metrical parameters and indices used to evaluate pancreatic B-cell function and insulin sensitivity. Analyzing the correlation between basic ind ices and glucose load indices in evaluating pancreatic B-cell function and insulin sensitivity. And finding the differences between basic indices and glucose load indices in correlating with the OGTT metrical parameters. Results: There were correlation between the basic and glucose load indices in evaluating islet B-cells function and insulin sensitivity (P ＜0.001). The glucose load indices used to evaluate pancreatic B-cell function and insulin sensitivity were all high correlated with the parameters derived from OGTT (P ＜0.05). But in basic indices, the homeostasis model of assessment of B-cell(HOMA-B) was not correlated with AUCgly(r ＝－0.198, P ＝0.116); insulin sensitivity index (IAI) was not correlated with AUCins(r ＝－0.216, P=0.088）. Conclusion: It is suggeste