论文部分内容阅读
60名单纯性肥胖老年人(65~85岁),另选择体重正常中老年人20名作为对照组,采用2小时口服糖耐量试验,胰岛素和C肽,空腹APN、高敏C反应蛋白(Hs-CRP)、肿瘤坏死因子(TNF-α)。胰岛素抵抗用胰岛素抵抗指数来评价,β细胞功能用注射葡萄糖30分钟前后的胰岛素和血糖变化(I30-I0/G30-G0)来评价。结果单纯性肥胖组13.33%存在糖耐量受损,8.33%患有2型糖尿病。糖耐量受损人群在糖负荷后胰岛素和C肽水平有所下降,而2型糖尿病老年人胰岛素和C肽水平进一步下降,30分钟胰岛素变化与血糖变化的比是下降的。胰岛素抵抗在糖耐量受损人群中是显著存在的。IGT及T2DM组TPN水平显著低于对照组及NGT组,Hs-CRP、TNF-α水平相反。结论在本地区单纯性肥胖老年人中,糖耐量受损高度流行,APN在肥胖及糖尿病发病过程中具有保护作用,细胞炎性因子表达异常是肥胖和糖尿病的独立危险因素。
Sixty simple obese elderly (65-85 years old) and 20 normal middle-aged and elderly adults were selected as control group. Two hours oral glucose tolerance test, insulin and C-peptide, fasting APN and Hs- CRP), tumor necrosis factor (TNF-α). Insulin resistance was assessed using the insulin resistance index, and β-cell function was assessed using changes in insulin and blood glucose 30 minutes after injection of glucose (I30-I0 / G30-G0). Results In simple obesity group, 13.33% had impaired glucose tolerance and 8.33% had type 2 diabetes mellitus. People with impaired glucose tolerance decline in insulin and C-peptide levels after glycemic load, whereas insulin and C-peptide levels decline further in type 2 diabetes mellitus, with a 30-minute decrease in insulin to blood glucose. Insulin resistance is prominent in people with impaired glucose tolerance. The levels of TPN in IGT and T2DM groups were significantly lower than those in control group and NGT group, and the levels of Hs-CRP and TNF-α were opposite. Conclusion Among the simple obesity elderly in our region, impaired glucose tolerance is highly prevalent. APN plays a protective role in the pathogenesis of obesity and diabetes. Abnormal expression of inflammatory cytokines is an independent risk factor for obesity and diabetes.