Zhang Yi-fei, Hong Jie, Gu Wei-qiong, Sun Shou-yue, Tang Jing-feng, Jiang Ling, Dai Meng, Zhao Yong-ju, Ning Guang
Department of Endocrinology, Rui-jin Hospital, Shanghai Second Medical University, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai 200025, China.
Zhonghua Nei Ke Za Zhi. 2003 Nov;42(11):793-6.
To investigate the relationship among fasting serum free fatty acid (FFA), insulin sensitivity index (ISI), serum triglyceride (TG) and total cholesterol (TC) levels in subjects with different body mass index (BMI) and glucose tolerance by using Bergman's minimodel method.
26 normal control subjects, 39 obese subjects, 25 impaired glucose tolerance (IGT) subjects and 21 patients with newly diagnosed type 2 diabetes mellitus (DM) were recruited into this study. Serum FFA level was measured with radioimmunoassay and ISI was obtained by using Bergman's minimal model method.
(1) In the four groups, serum FFA concentration of the control group was significantly lower than that of the other three groups, although there was no difference among the latter three. (2) ISI level of the control group was significantly higher than that of other three groups, while there was no difference among the latter three. (3) After adjusting with BMI, there was still significant difference in serum FFA levels between the control and the other three groups. (4) ISI, HOMAIR, BMI, waist hip ratio (WHR) and TG were all related to the concentration of serum FFA (r = -0.454, 0.213, 0.241, 0.336 and 0.414 respectively, P < 0.01, < 0.05, < 0.05, < 0.01 and < 0.01 respectively), while age, sex and serum TC levels were not related with serum FFA. (5) According to multivariate stepwise regression, ISI, BMI and TG were the major determinant factors for FFA (R(2) = 0.109, 0.212, 0.156, P < 0.001).
Besides BMI, ISI and serum TG level are the major determinant factors that affect the concentration of serum FFA. As compared with the simple index HOMAIR, ISI level was more significantly related with serum FFA concentration. FFA levels are significantly different in various glucose tolerant states even after adjusting with BMI. FFA levels were obviously higher in subjects with IGT or type 2 diabetes mellitus.
采用伯格曼最小模型法，研究不同体重指数（BMI）和糖耐量受试者空腹血清游离脂肪酸（FFA）、胰岛素敏感指数（ISI）、血清甘油三酯（TG）及总胆固醇（TC）水平之间的关系。
本研究纳入26名正常对照者、39名肥胖者、25名糖耐量受损（IGT）者和21名新诊断的2型糖尿病（DM）患者。采用放射免疫法测定血清FFA水平，并用伯格曼最小模型法计算ISI。
（1）四组中，对照组血清FFA浓度显著低于其他三组，而后三组之间无差异。（2）对照组ISI水平显著高于其他三组，而后三组之间无差异。（3）校正BMI后，对照组与其他三组血清FFA水平仍有显著差异。（4）ISI、稳态模型评估胰岛素抵抗指数（HOMAIR）、BMI、腰臀比（WHR）和TG均与血清FFA浓度相关（r分别为-0.454、0.213、0.241、0.336和0.414，P分别<0.01、<0.05、<0.05、<0.01和<0.01），而年龄、性别和血清TC水平与血清FFA无关。（5）根据多元逐步回归分析，ISI、BMI和TG是FFA的主要决定因素（R²分别为0.109、0.212、0.156，P<0.001）。
除BMI外，ISI和血清TG水平是影响血清FFA浓度的主要决定因素。与简单指标HOMAIR相比，ISI水平与血清FFA浓度的相关性更显著。即使校正BMI后，不同糖耐量状态下FFA水平仍有显著差异。IGT或2型糖尿病患者的FFA水平明显更高。
