| Objective To investigate clinical features, β cell function and insulin resistance in elderly DM high-risk subjects . Methods Screening for DM was runned in officers who attended medical examination in General Hospital of PLA in the May of 2005 and May of 2006. DM patients were excluded. The others took 100g steamed bread in oral after blood taken. Their finger blood glucose was measured after 2h, and high risk subjects with glucose≥7.2mmol/L were given OGTT. 650 patients entered into the research, among them, the number of male 579 and the number of female 71. Glucose and insulin of Oh, 1h and 2h were measured. Grouped by age and glycometabolism status, the different glycometabolism status among age groups and clinical features among glycometabolism status groups were analyzed. β cell function and insulin resistance were compared among five groups. Insulin resistance were determined by HOMA-IR, and β cell function were determined by HOMA-β and △I60/G60. Correlation factor of β cell function and insulin resistance were analyzed. Results ①The most of our research subjects were elderly male, male age was obviously higher than female. Mean BMI of male and female were all in overweight limits.②The proportion of abnormal glycometabolism was more than normal subjects, the ratio of t2dm was 8.6% and the ratio of IGT was 39%, morbidity rate of abnormal glycometabolism increased with age growth.③ Foundation insulin secretion change trend displayed stronger secretion function in the elderly newly diagnostic DM and IGT , even higher than that in NGT and IFG. β cell function after 1h loaded showed a gradually decreased trend according to the order of NGT→IGT → IFG→IFG + IGT→DM. Insulin resistance showed a gradually increased trend according to the order of NGT →IFG→ IGT→ IFG + IGT→ DM. ④Abnormal glycometabolism group has higher ratios of obesity, hypertension, hyperuricemia, lipid metabolism disorder and angiocardiopathy than those of normal glycometabolism group. ⑤ Spearman correlation analysis of insulin resistance showed: Homa-IR had relationship with FINS, INS2h, INS1h, BMI, waistline, OGTT0h, OGTT2h, WHR, OGTT1h, SBP and DBP. Spearman correlation analysis of β cell function showed: HBCI had positive relationship with FINS, INS2h, INS1h, BMI, waistline and WHR, negative relationship with OGTT0h. Conclusion Morbidity rate of abnormal glycometabolism increased with age growth. Obesity is a common feature in the high risk subjects. Insulin resistance is general existence, but β cell compensation function is comparatively higher in elderly DM high risk subjects.Objective To investigate clinical features and influential factors of elderly male with hyperinsulinemia. Methods 521 high-risk elderly males screened for DM were given oral 75g glucose tolerance test, and divided into hyperinsulinemia group and normal insulinemia group according to the insulin levels. Clinical features, glycometabolism state constituent ratio , other combined diseases , β cell function and insulin resistance were compared between two groups. Insulin resistance were determined by HOMA-IR, and β cell function were determined by HOMA-β. The relationship between glycometabolism state change and body weight was analyzed in hyperinsulinemia patients 2-10 years ago. Results Compared with normal insulinemia group, hyperinsulinemia group has higher values of BMI, waistline, FPG, PG2h, SBP, DBP and lower value of HDL-C. There were no significant differences in average age, TC, WHR and LDL-C between two groups. Glycometabolism abnormality detection rate was higher in hyperinsulinemia group, β cell function and insulin resistance index were higher in hyperinsulinemia VS normal insulinemia . Hyperinsulinemia group has higher ratios of obesity, hypertension, hyperuricemia and angiocardiopathy compared to normal insulinemia group. Change in body weight was one of the influencing factors in evaluating the outcome of carbohydrate tolerance.Conclusions In most elderly male with hyperinsulinemia, β cell function was within normal range but ratios of metabolism abnormality, CD and CVD were higher. Therefore, special attention and integrated control should be performed.
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