Chailurkit La-or, Jongjaroenprasert Wallaya, Chanprasertyothin Suwannee, Ongphiphadhanakul Boonsong
Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Clin Lab Anal. 2007;21(2):85-90. doi: 10.1002/jcla.20138.
Impaired pancreatic beta cell function and insulin sensitivity are fundamental factors in the pathogenesis of type 2 diabetes; however, the predominant defect appears differ among ethnic groups. We conducted a cross-sectional study to evaluate the contribution of impaired beta cell function and insulin sensitivity at different stages of the deterioration of glucose tolerance in Thais. The study involved 420 urban Thais of both sexes, 43-84 years old. A 75-g oral glucose tolerance test was performed on all of the subjects. Indices of insulin resistance and beta cell function were calculated with the use of a homeostasis model assessment. The subjects were classified as having normal glucose tolerance (NGT), isolated impaired fasting glucose (IFG), isolated impaired glucose tolerance (IGT), combined IFG and IGT, or type 2 diabetes mellitus according to the American Diabetes Association (ADA) criteria. There were no differences between groups with regard to gender and age. The percentage of obesity was significantly greatest in the diabetic group. Fasting serum insulin and C-peptide levels progressively increased from the NGT to the diabetic subjects. Serum C-peptide was more strongly associated with newly diagnosed diabetes than insulin, and was an independent factor associated with newly diagnosed diabetic subjects. The insulin resistance index progressively increased when the glucose tolerance stage changed from NGT through diabetic subjects. Beta cell function did not change significantly in any other group compared to the NGT group. An increase in fasting serum C-peptide may be a risk factor for type 2 diabetes. Obesity and insulin resistance are the predominant features in the deterioration of glucose tolerance in Thais.
胰腺β细胞功能受损和胰岛素敏感性降低是2型糖尿病发病机制的基本因素；然而，主要缺陷在不同种族群体中似乎有所不同。我们进行了一项横断面研究，以评估泰国人糖耐量恶化不同阶段β细胞功能受损和胰岛素敏感性降低的作用。该研究纳入了420名年龄在43至84岁之间的泰国城市居民，男女皆有。所有受试者均进行了75克口服葡萄糖耐量试验。使用稳态模型评估计算胰岛素抵抗和β细胞功能指标。根据美国糖尿病协会（ADA）标准，将受试者分为糖耐量正常（NGT）、单纯空腹血糖受损（IFG）、单纯糖耐量受损（IGT）、IFG合并IGT或2型糖尿病。各组之间在性别和年龄方面无差异。肥胖百分比在糖尿病组中显著最高。空腹血清胰岛素和C肽水平从NGT组到糖尿病组逐渐升高。血清C肽与新诊断糖尿病的相关性比胰岛素更强，并且是与新诊断糖尿病患者相关的独立因素。当糖耐量阶段从NGT转变为糖尿病组时，胰岛素抵抗指数逐渐升高。与NGT组相比，其他任何组的β细胞功能均无显著变化。空腹血清C肽升高可能是2型糖尿病的一个危险因素。肥胖和胰岛素抵抗是泰国人糖耐量恶化的主要特征。
