Lü Qingguo, Tong Nanwei, Liu Yupu, Li Nali, Tang Xialian, Zhao Jianlin, Cao Hongyi, Li Daigang, Gou Lingli, Zhang Yuwei, Wan Jun, Jiang Li
Department of Endocrinology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Diabetes Res Clin Pract. 2009 Jun;84(3):319-24. doi: 10.1016/j.diabres.2009.03.002.
To investigate alterations of insulin resistance (IR), chronic inflammation and urine albumin-to-creatinine ratio (ACR) in Chinese community-based prediabetic population.
252 prediabetics [prediabetes (PD), including impaired fasting glucose (IFG), 91; impaired glucose tolerance (IGT), 123; IFG+IGT, 38] and 38 newly diagnosed-diabetics (NDDM) aged over 35 years older were screened from 2336 community individuals. 123 age and gender matched individuals with normal glucose tolerance (NGT) were selected as controls. Serum adiponectin, interleukin-6 (IL-6) levels and urine ACR were determined, HOMA-IR and Gutt's index were calculated to evaluate IR and insulin sensitivity, respectively.
The data displayed significant difference of serum adiponectin, IL-6, ACR and Gutt's index among PD, NDDM and NGT groups. Adiponectin level and Gutt's index decreased, but IL-6 level and ACR increased gradually among NGT, PD and NDDM groups (P<0.01). Unlike adiponectin and IL-6, ACR analysis indicates a gradual increase from NGT, IFG, IGT, IFG+IGT to NDDM individuals (P<0.01). Gutt's index showed significant difference between IFG and NDDM, IFG+IGT and NDDM (P<0.01), but HOMA-IR index did not.
IR, chronic inflammation and endothelial dysfunction dose exist in prediabetic individuals, especially in IFG+IGT population. Gutt's index and ACR might seem to be more sensitive than adiponectin and HOMA-IR index as IR and chronic inflammation maker in prediabetic population.
研究中国社区糖尿病前期人群中胰岛素抵抗(IR)、慢性炎症及尿白蛋白肌酐比值(ACR)的变化。
从2336名社区个体中筛选出252例年龄超过35岁的糖尿病前期患者[糖尿病前期(PD),包括空腹血糖受损(IFG)91例、糖耐量受损(IGT)123例、IFG+IGT 38例]和38例新诊断糖尿病患者(NDDM)。选取123例年龄和性别匹配的糖耐量正常(NGT)个体作为对照。测定血清脂联素、白细胞介素-6(IL-6)水平及尿ACR,计算HOMA-IR和Gutt指数分别评估IR和胰岛素敏感性。
数据显示PD、NDDM和NGT组之间血清脂联素、IL-6、ACR和Gutt指数存在显著差异。在NGT、PD和NDDM组中,脂联素水平和Gutt指数降低,而IL-6水平和ACR逐渐升高(P<0.01)。与脂联素和IL-6不同,ACR分析表明从NGT、IFG、IGT、IFG+IGT到NDDM个体逐渐升高(P<0.01)。Gutt指数在IFG与NDDM、IFG+IGT与NDDM之间存在显著差异(P<0.01),但HOMA-IR指数无差异。
糖尿病前期个体中确实存在IR、慢性炎症和内皮功能障碍,尤其是在IFG+IGT人群中。作为糖尿病前期人群IR和慢性炎症标志物,Gutt指数和ACR可能比脂联素和HOMA-IR指数更敏感。