The Relation Of One-Hour Postloade Plasma Glucose With Isletcell Function And Inflammatory Factor

Objective: To investigate early phase insulin secretion of one hour hyperglycemia; To compare relationship between one-hour postload plasma glucose(1hPG)and two-hour postload plasma glucose(2hPG) with function of beta Cell of islet, insulin resistance, inflammatory factor,blood fat; search cut point of 1hPG and the possible role in prevention and cure in prediabetes.Methods: OGTT and OGIRT were carried out in type 2 diabetes(T2DM), impaired glucose tolerance(IGT), normal glucose tolerance(NGT) but 1hPG exceed 8.0mmol/L (HIGH-NGT) and normal glucose tolerance but 1hPG lower than 8.0mmol/L (LOW-NGT). Measure the plasma glucose and insulin of empty stomach, 30min, 1hour and 2hour.Plasma HsCRP and TNF-αwere assayed by immunoturbidimetry and radioimmunity in four groups.The relationship between 1hPG and HOMA-IR, HOMA-β, 30minIns, AUC30INS, HsCRP, TNF-αwere also analyzed.Results: (1)The function of beta Cell of islet were changed in prediabetes with 1hPG exceed 8.0mmol/L. (2) Early phase insulin secretion were descended from LOW-NGT to T2DM.The levels of 30minIns and AUC30INS in HIGH-NGT were significantly lower than that in LOW-NGT(P<0.05) and higher than that in IGT(P<0.05)(.3)HOMA-βwere descended from LOW-NGT to T2DM. The levels of HOMA-βin HIGH-NGT were significantly lower than that in LOW-NGT(P<0.05) and higher than that in IGT(P<0.01). HOMA-IR were upgraded from LOW-NGT to T2DM. The levels of HOMA-IR in HIGH-NGT were significantly higher than that in LOW-NGT(P<0.01) and lower than that in IGT(P<0.01).(4) TNF-αand Hs-CRP were upgraded from LOW-NGT to T2DM. The levels of TNF-αand Hs-CRP in HIGH-NGT were significantly higher than that in LOW-NGT (P<0.01and P<0.05) and similar with IGT(P>0.05).(5) 1hPG were positively correlated with HOMA-IR, TNF-α, TG, SBP, HsCRP, FIns(r=0.631; r=0.425; r=0.382; r=0.320; r=0.275; all P<0.01 and r=0.224 P<0.05)and negatively with HOMA-β, 30minIns, AUC30INS and HDL-C(r=-0.597; r=-0.410; r=-0.357; r=-0.297; all P<0.01 ) .The correlation of HOMA-IR, SBP, FIns, 30minIns , AUC30INS, HOMA-β, HDL-C, TG, TNF-αwith 1hPG were harder than that with 2hPG.(6) Multiple regression analysis showed that HOMA-IR, HOMA-β, 30minIns, TG and HsCRP were independent related factors influencing 1hPG.Conclusion: The function of beta Cell of islet is decreased and early phase insulin secretion is reduced in NGT with 1hPG exceed 8.0mmol/L and there are insulin resistance and Chronic inflammatory reaction in it.We can regard one hour postload hyperglycemia as prophase of IGT. one hour postload plasma glucose is correlated with development of IGT or diabetes and vascular lesion.