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目的初步分析南宁市群体中影响胰岛素分泌的因素。方法随机分层抽取广西南宁市部分事业单位人员7902例。取背景人群(NGT人群,n=5642),除外糖尿病和葡萄糖调节受损患者,用HOMA模型评价胰岛素分泌(IS),以低于NGT人群HOMA-IS的下1/4=4.8643为诊断胰岛素分泌功能降低标准。同时,借助于多因素分析手段控制组织胰岛素敏感性对分析结果的影响。结果1.偏相关分析显示,在控制体重指数(BMI)和胰岛素抵抗指数的影响后,胰岛素分泌与年龄、腰围、空腹及餐后血糖、收缩压、血脂水平负相关,与性别无相关。其中相关系数最大的两个变量为血糖和年龄。2.协方差分析显示,在控制BMI和胰岛素抵抗指数的影响后,在NGT、IGT、IFG和DM的分组次序中,HOMAIS逐渐降低。同时,随增龄HOMAIS也逐渐降低。结论控制组织胰岛素敏感性的影响后,可以在流行病学研究中用HOMA模型评价个体胰岛素分泌功能。南宁市群体胰岛素分泌功能主要受血糖水平和增龄的影响,并且空腹葡萄糖受损较葡萄糖耐量降低对胰岛素分泌的影响更大。
Objective To analyze the factors influencing insulin secretion in Nanning population. Methods Randomly stratified 7902 cases of some institutions in Nanning, Guangxi. Patients in the background (NGT population, n = 5642), except for those with impaired diabetes and impaired glucose regulation, were evaluated for insulin secretion using the HOMA model (IS), insulin secretion was measured at 1/4 = 4.8643 lower than in NGOM population HOMA-IS Function to reduce the standard. At the same time, by means of multivariate analysis to control the impact of tissue insulin sensitivity on the results of the analysis. Partial correlation analysis showed that insulin secretion was negatively correlated with age, waist circumference, fasting and postprandial blood glucose, systolic blood pressure and blood lipid, and had no correlation with gender after controlling for body mass index (BMI) and insulin resistance index. The two variables with the highest correlation coefficient were blood glucose and age. Analysis of covariance showed that HOMAIS gradually decreased in the grouping order of NGT, IGT, IFG and DM after controlling the influence of BMI and insulin resistance index. At the same time, with age HOMAIS also gradually decreased. Conclusions After controlling for the effects of insulin sensitivity, HOMA models can be used to evaluate individual insulin secretion in epidemiological studies. The insulin secretion function of Nanning population is mainly affected by blood glucose level and aging, and impaired fasting glucose has a greater impact on insulin secretion than impaired glucose tolerance.