Observation And Analysis Of Pancreatic Isletβ Cells And Insulin Resistance In Impaired Glucose Regulation

With the progress of society,people lifestyle are changing,but the incidence of diabetes are increasing year by year .Diabetes has become the third largest infectious disease following after the cardiovascular diseases and cancer,and diabetes brings the enormous economic burden of human society.The current research on the pathogenesis of diabetes is still not very clear,and many studies have shown that the incidence of diabetes associated with isletβcell damage and insulin resistance In recent years.Impaired glucose regulation(IGR) are also associated with isletβcell damage and insulin resistance .the incidence of IGR are increasing year by year,especially in developing countries.The current impaired fasting glucose (IFG), impaired glucose tolerance (IGT) was not consistent in the study of insulin resistance and pancreaticβ-cell function.This paper analyzes the IGR groupβ-cell function and insulin resistance,and provide a theoretical basis for the reasonable intervention in patients with abnormal glucose metabolism.Impaired glucose regulation (IGR) people should be diagnosed early,and be rational and effective therapeutic intervention,which would reduce the incidence of diabetes and economic burden of society.Objective:By studying the impaired glucose regulation (IGR) changes of pancreatic isletβ-cell function,which will provide a theoretical basis for different abnormal glucose metabolism in patients with individualized drug treatment program options.Methods:object of study:135 patients were diagnosed as impaired glucose regulation in our hospital (Jilin University, China-Japan Friendship Hospital) endocrine out-patient and hospitalization from March 2008 to October 2009.There are 39 cases diagnosed as impaired fasting glucose regulation(IFG).There are 40 cases diagnosed as impaired glucose tolerance(IGT).There are 56 cases diagnosed as impaired fasting glucose regulation combined with impaired glucose tolerance(IFG+IGT).In the 135 patients there are 75 males and 60 females, their age 25-65 years, mean age 47±11.135 patients had no liver, kidney, thyroid disease, and they do not use insulin and hypoglycemic drugs.The normal group:there were 20 cases of healthy physical examination in our hospital, including 12 cases of males, 8 females, age 22-72 years, mean age 42±13.1997 American Diabetes Association (ADA) diagnostic criteria for classification as a standard, the above object of study of islet cell function and insulin resistance were analyzed.Each case subjects had to be done to 75g oral glucose tolerance test, and was drawn venous blood, using glucose oxidase method of measuring fasting blood glucose (FBG), blood glucose 1h after oral glucose (OGTT1hPG), after 2h oral glucose blood glucose (OGTT2hPG) in the United States to complete the Beckman automatic biochemical analyzer.Each subjects was tested fasting insulin (FINS) by radioimmunoassay.Subjects in each case was measured blood pressure (mmHg), height (m), weight (kg).We calculate the body mass index [BMI (kg / m2) = weight / height 2].In the basic state, the insulin secretion index (HBCI) = 20×FINS / (FPG-3.5).Evaluation of insulin resistance :insulin resistance index HOMA-IR = (FINS×FBG) / 22.5.Evaluation of islet function after glucose loading: Leeβ-cell insulin secretion index (MBCI) = (FINS×FBG) / (PG2h + PG1h-2FBG) .Insulin sensitivity index (IAI) = 1 / (FBG×FINS).Statistical data processing uses the SPSS 17.0 statistical software package.The data with x±s show, non-normal data must become a normal distribution through natural logarithmically transformed before statistics. The mean of groups was compared by single-factor analysis of variance.It is statistically significant for P<0.05.Results:(1) Comparison of body mass index and blood pressure of the four groups :BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP) of IFG group, IGT group and IFG + IGT group were higher than the normal control group,and there is a significant statistical difference between them and the normal control group(P<0.05).BMI, SBP and DBP of IFG group and IGT groups was no significant difference (P> 0.05).BMI, SBP and DBP of IFG + IGT group is higher than the IFG group and IGT group.There is a statistically significant (P <0.05)difference between SBP of IFG Group and SBP of IFG + IGT group. BMI and DBP is no significant difference among the IFG + IGT group,the IFG group and the IGT group (P> 0.05).(2) The basic state insulin secretion and insulin secretion after OGTT load:HBCI of IFG and IFG + IGT group are significantly lower than NGT group (P <0.05). HOMA-βof IGT group is lower than in NGT group and is no significant difference with NGT (P> 0.05); the difference of IGT group with IFG and IFG + IGT group was statistically significant (P <0.05) .HOMA-βof IGT group and IFG + IGT group is significantly lower than IFG group and NGT group;there is no significant difference between NGT group and IFG group;IGT group and IFG + IGT group was significantly lower than the IFG group (P <0.05),differences of IGT and IFG + IGT group is statistically significant (P <0.05).(3) insulin sensitivity: insulin sensitivity index (IAI) of IFG group and the IGT group and IFG + IGT groups is lower than the NGT group, and the difference of the NGT group and the other three groups are significant (P <0.05);there is no significant difference between IFG Group and IFG + IGT group (P> 0.05). The HOMA-IR of NGT group is significantly lower than the other 3 groups (P <0.05),and there is no significant difference between IFG group and IFG + IGT group(P> 0.05).The difference IGT group with IFG group and IFG + IGT group is significant(P <0.05).Conclusion: 1. The pancreaticβcell function and insulin resistance of different subtypes impaired glucose regulation (IGR) are different: Impaired fasting glucose (IFG) mainly shows on based insulin secretion defect and hepatic insulin resistance; impaired glucose tolerance (IGT)mainly shows on the insulin secretion defect after glucose loading and insulin resistance in peripheral tissues; fasting impaired glucose regulation combined with impaired glucose tolerance (IFG + IGT) shows on based insulin secretion defect and insulin secretion defect after glucose loading and insulin resistance.2. According to the isletβcell function's pathological changes of impaired glucose regulation in different subtypes ,we will give early,rational and individual intervention which would be effective in preventing the occurrence and development of diabetes, and has profound clinical significance in reducing the incidence of diabetes.