不同诊断标准中国人群代谢综合征胰岛素敏感性和β细胞功能的研究
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A investigation of insulin sensitivity and β cell functions in subjects with or without MS according to different diagnosis standards
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    目的:探讨中国人群代谢综合征(MS)与胰岛素抵抗的相关性,评价经ATPⅢ及IDF诊断标准诊断的MS者是否具有WHO诊断标准所要求的胰岛素抵抗-方法:以110例老年医学科的住院患者为研究对象,按照2001年美国ATPⅢ及2005年IDF对MS的诊断标准,用稳态模型(HOMA) 方法评估各组人群中胰岛素的敏感性及胰岛β细胞功能-结果:以ATPⅢ为标准时,非合并MS(72例)和合并MS(38例)组的HOMA-IR分别为1.50 ± 1.84和2.15 ± 2.50(P = 0.13),HOMA-β细胞功能分别为0.90 ± 0.56和0.96 ± 0.94(P = 0.68);以IDF为标准时,非合并MS(56例)和合并MS(54例)组的HOMA-IR分别为1.25 ± 0.83和2.22 ± 2.81(P = 0.01),HOMA-β细胞功能分别为0.87 ± 0.56和0.98 ± 0.85(P = 0.41)-结论:在本研究中ATPⅢ定义的MS并不存在明显的胰岛素抵抗,提示在中国人群诊断MS时ATPⅢ标准和WHO诊断标准存在明显分歧-而IDF标准诊断的MS具有明显的胰岛素抵抗,可能更适合中国人群-

    Abstract:

    Objective:To investigate the correlation between metabolic syndrome(MS) and insulin resistance in Chinese,discuss the applicability of ATPⅢ criteria and IDF criteria for MS in Chinese people. Methods:Given 75 g oral glucose tolerance challenge,110 Chinese were divided into normal glucose tolerance(NGT) group, impaired glucose tolerance(IGT) group and type 2 diabetes (DM) group according to 1999 WHO criteria. Homeostasis model assessment (HOMA) was applied to assess the status of insulin resistance(HOMA-IR) and basic function of pancreatic -茁 cell(HOMA--茁 cell). Results:In subgroups with and without MS according to the ATPⅢ criteria, no significant difference was found in HOMA-IR(1.50 ± 1.84,2.15 ± 2.50,P = 0.13) and HOMA--茁 cell(0.90 ± 0.56,0.96 ± 0.94,P = 0.68). However,in subgroups according to IDF criteria,significant difference was found in HOMA-IR(1.25 ± 0.83,2.22 ± 2.81,P = 0.01). Conclusion:There was no distinct insulin resistance in the metabolic syndrome group defined by the 2001 ATPⅢ criteria. The ATPⅢ criteria for MS was not coherent with the 1999 WHO criteria. The ATPⅢ criteria for MS might not have enough applicability in Chinese patients, while the IDF criteria might be more applicable in Chinese people.

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程 鹏,刘 娟,张爱森,丁国宪.不同诊断标准中国人群代谢综合征胰岛素敏感性和β细胞功能的研究[J].南京医科大学学报(自然科学版),2008,28(1):56-59

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  • 收稿日期:2007-07-29
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