| ObjectiveObesity and diabetes are human health stumbling block on road. In developed and developing countries,morbidity and mortality rate is rising year by year into the trend. And it also suffer from diabetes and obesity among patients, especially with heterotaxy model fat (visceral fat tissue accumulation be caused by) and insulin resistance (IR) relationship more and more much attention. Studies have confirmed that the accumulation of visceral fat in insulin resistance of type2diabetes rates increase is one of many factors. This article will first visit to the patients with type2diabetes in different body parts adipose tissue accumulation (subcutaneous, visceral, and liver) and insulin resistance is a close relationship between the different understanding of fat distribution type2diabetes islet cell function change and the β insulin therapy intensified, by comparing the blood sugar, blood fat, glycated hemoglobin, islet β cell function, insulin resistance (IR) and the change of the dose of insulin, analyzes adipose tissue under the skin, visceral, and liver accumulation three groups of the relationship between patients with insulin resistance.MethodsGlycated hemoglobin (HbAlc) the standard of7%of selected quartile surveyed T2DM (accord with type2diabetes diagnosis standard) according to the waist/hip patients than WHR:male>0.90, the female>0.85and/or body mass index (BMI)>30kg/m2central obesity in selected60cases. Toshiba790B ultrasonic diagnosis application of FL30cases. Sixty cases of center type obese patients with rich feet prosperous hong method for determining visceral fat index (UVI), which is divided into UVL>3.0of visceral model fat34cases, UVL<3.0subcutaneous model fat group26cases. Health TiJianZu30cases. Four groups of patients were empty tewelve hours in the early of the morning with measuring height (accurate to lcm), weight (accurate to0.2kg), waist circumference (accurate to0.5cm), hip circumference (accurate to0.5cm), calculated the BMI=weight (kg)/height (cm)2; WHR=waistline/hip circumference. Early morning hollow extraction cubits venous blood, measurement of fasting blood sugar (FBG), fasting insulin (FINS), triglycerides (TG), total cholesterol (TC), low dense lipoprotein cholesterol (LDL), high-density lipoprotein (HDL) cholesterol, glycated hemoglobin (HbA1c). Will75g anhydrous glucose powder insoluble in300mL water,5minutes utterly one-time drink oral glucose tolerance test,2hours take venous blood check hBG2,2hINS. Calculation of islet cell functionβ[Homaβ=20×fasting insulin(mIU/L)/(fasting blood sugar (mmol/L)-3.5)], insulin sensitivity index (ISI):the ISI=1/fasting blood sugar(mmol/L)×fasting insulin (mIU/L), insulin resistance index (homa-ir)=FBG(mmol/L)×FIns (mIU/L)/22.5. HOMA-IS=20×FINS(mIU/L)/(FPG (mmol/L)-3.5) with statistical many factors variance analysis IS three groups of patients and normal health group waist circumference, waist-hip ratio, body mass index, fasting blood sugar, blood sugar, HOMA β, HomaIR, HomaIS. Three groups of patients, insulin therapy intensified by after3months, all discontinuation external insulin, fasting blood glucose, blood fat, check HbAlc, insulin, use matching t test sample were compared before and after three groups of insulin treatment, the TC TG, LDL-C, hdl-c, FBG, FINS, HbAlc, Homa β, HomaIR and the use of the dose of insulin.Glycated hemoglobin (HbAlc) the standard of7%of selected quartile surveyed T2DM (accord with type2diabetes diagnosis standard) according to the waist/hip patients than WHR:male>0.90, the female>0.85and/or body mass index (BMI)>30kg/m2central obesity in selected60cases. Toshiba790B ultrasonic diagnosis application of FL30cases. Sixty cases of center type obese patients with rich feet prosperous hong method for determining visceral fat index (UVI), which is divided into UVL>3.0of visceral model fat34cases, UVL<3.0subcutaneous model fat group26cases. Health TiJianZu30cases. Four groups of patients were fast ewelve hours in the early of the morning with measuring height (accurate to1cm), weight (accurate to0.2kg), waist circumference (accurate to0.5cm), hip circumference (accurate to0.5cm), calculated the BMI=weight(kg)/height(cm)2; WHR=waistline/hip circumference. Early morning hollow extraction cubits venous blood, measurement of fasting blood sugar (FBG), fasting insulin (FINS), triglycerides (TG), total cholesterol (TC), low dense lipoprotein cholesterol (LDL), high-density lipoprotein (HDL) cholesterol, glycated hemoglobin (HbA1c). Will75g anhydrous glucose powder insoluble in300mL water,5minutes utterly one-time drink oral glucose tolerance test,2hours take venous blood check2hBG,2hINS. Calculation of insulin cell function B[Homaβ=20×fasting insulin (mIU/L)/(fasting blood sugar (mmol/L)-3.5], insulin sensitivity index (ISI):the ISI=1/fasting blood sugar (mmol/L)×fasting insulin (mIU/L), insulin resistance index (homa-ir)=FBG(mmol/L)×FIns (mlU/L) /22.5. HOMA-IS=[20×FINS (mIU/L)/(FPG (mmol/L)-3.5] with statistical many factors variance analysis is three groups of patients and normal health group waist circumference, waist-hip ratio, body mass index, fasting blood sugar, blood sugar,2hours after a meal glycosylated hemoglobin, blood fat, fasting insulin, two hours after a meal insulin and ISI, HOMA β, HomaIR, HomaIS. Three groups of patients, insulin therapy intensified by after3months, all discontinuation external insulin, fasting blood glucose, blood fat, check HbAlc, insulin, use matching test sample were compared before and after three groups of insulin treatment, the TC TG, LDL-C, hdl-c, FBG, FINS, HbAlc, Homa β, HomaIR and the use of the dose of insulin.Results1. Between each gender, age, duration, systolic blood pressure and diastolic blood pressure comparison.(1) the type2diabetes age, sex, and course have difference, but this was not statistically significant.(2) the subcutaneous fat group, fatty liver group and control group more than normal elevated systolic blood pressure, statistically significant (p<0.05,p<0.01), visceral fat and fatty liver group group compared with normal diastolic blood pressure, statistically significant (p<0.05).2.body fat different distribution in patients with type2diabetes WC, BMI, WHR comparison.(1) subcutaneous fat group, fatty liver group and normal control group is WC have statistical significance(p<0.05); Visceral fat group and in the normal control group (p<0.01).(2) the fatty liver group and control group is normal BMI was statistically significant(p<0.05); Subcutaneous fat group and visceral fat group compared with normal BMI(p<0.01).(3) subcutaneous fat group and fatty liver group compared with normal WHR difference have statistically significant (p<0.05), visceral fat group and control group compared with normal significant difference (p<0.01).3body fat different distribution in patients with type2diabetes FBG,2HBG, FINS,2FINS, HbAlc comparison.(1) The normal control group is a significant rise FBG, significant difference (p<0.01); Visceral fat group group compared with subcutaneous fat FBG significant difference (p<0.01).(2) each group compared with normal2HBG difference was statistically significant (p<0.05); Visceral fat group, fatty liver group and subcutaneous fat group compared2HBG(p<0.01); Visceral fat group group compared with fatty liver is statistically significant difference (p<0.05).(3) visceral fat group, fatty liver group compared with normal FINS significantly increased, significant difference (p<0.01); Subcutaneous fat group compared with normal FINS are statistically significant difference (p<0.05);(4)visceral fat group, fatty liver group compared with normal2HINS significantly increased, significant difference (p<0.01); Subcutaneous fat group compared with normal2HINS difference have statistically significant (p<0.05); Visceral fat group group compared with fatty liver is statistically significant difference (p<0.05).(5) compared with the normal group HbAlc difference was statistically significant(p<0.05); Subcutaneous fat group compared with normal HbAlc difference was statistically significant(p<0.05); Visceral fat group group compared with fatty liver HbAlc is statistically significant difference (p<0.05).4. Body fat different distribution in patients with type2diabetes LDL, TG, TC, HDL comparison.(1) with the normal control group is a significant rise LDL, significant difference (p<0.01); The fat group and subcutaneous fat group, fatty liver group compared elevated LDL, the difference was statistically significant (p<0.05).(2) the subcutaneous fat group, the visceral fat group and fatty liver group and in the normal control group is a significant rise TG, significant difference (p<0.05,p<0.01); Visceral fat group and subcutaneous fat group, fatty liver group compared elevated LDL, the difference was statistically significant (p<0.05,p<0.01); Subcutaneous fat group group compared with fatty liver is statistically significant difference (p<0.05).(3) visceral fat group and fatty liver group compared with normal TC significantly increased, significant difference (p<0.01); Visceral fat group and subcutaneous fat group compared TC increases, the difference was statistically significant (p<0.05).(4) the visceral fat group group compared with subcutaneous fat lower HDL, a statistically significant (p<0.05); Subcutaneous fat group, fatty liver group and normal group compared to reduce, not statistically significant (p>0.05).5. Body fat different distribution in patients with type2diabetes Homa β, HomaIR, ISI, Homa-IS,(1) each group compared with normal Homa β significantly reduced, significant difference (p<0.01); Visceral fat group compared subcutaneous fat group, fatty liver Homa β reduce group (p<0.05).(2) the visceral fat group, fatty liver group compared with normal HomaIR increases, differences have obvious statistical significance (p<0.01).(3) HOMA groups-IS more normal controls were lower, visceral fat group compared HOMA-IS lower there was a significant difference (p<0.01), fatty liver groups was statistically significant comparative differences (p<0.05),subcutaneous fat group compared to normal lower, but this was not statistically significant (p>0.05); Visceral fat group group compared with subcutaneous fat HOMA-IS difference have obvious statistical significance (p<0.01); Visceral fat group group compared with fatty liver HOMA-IS statistically significant difference (p<0.05)(4) compared with normal the ISI has significant results difference (p<0.01); Visceral fat group compared subcutaneous fat are statistically significant differences between the ISI group (p<0.05); Visceral fat group group compared with fatty liver was not statistically significant difference (p>0.05), visceral fat group and fatty liver is ISI statistical significance was found between (p<0.05).6. Subcutaneous fat group, the visceral fat group, fatty liver group three groups before and after the insulin therapy insulin resistance index comparison.(1) subcutaneous fat group, fatty liver groups before treatment compared with after treatment, TG, TC, LDL-C, FBG, HbA1C, LDL-C, HDL-C, FINS, Homap increases, differences were significantly statistical significance (p<0.01);(2) the visceral fat group therapy intensified after insulin after TG, TC, LDL-C, FBG, Hbalc are lower, hdl-c, FINS, Homa β increases, the difference was statistically significant (p<0.05).(3) subcutaneous fat group and fatty liver after the treatment group daily dosage Ins less than visceral fat group therapy, the difference was statistically significant (p<0.05).Conclusion1.The subcutaneous fat increase group, the visceral fat increase group, fatty liver group high-risk T2DM patients first visit there exists different degree of beta cell function decline and different degree of IR, especially with more visceral fat group is the most obvious, followed by fatty liver group and and subcutaneous fat increase group.2. Both the individual T2DM there exists different degree of blood lipid metabolic disorder, with insulin resistance the most obvious visceral fat increase of the patients the most serious.3. Early insulin therapy intensified surveyed T2DM, subcutaneous fat increase group and fatty liver group compared with before treatment blood sugar, blood fat, reduce glycated hemoglobin, HomaIR index reduce, Homa β index increased, insulin ss-cell function have improved significantly statistical significance. Visceral fat group therapy intensified after insulin after blood sugar, blood fat, reduce glycated hemoglobin, HomaIR index reduce, Homa β index increase, the difference was statistically significant. First visit of T2DM insulin resistance to the improvement of the group is the most obvious subcutaneous fat, followed by fatty liver group, visceral fat increase group minimum changes, show that visceral fat increase insulin resistance level of the most obvious. Three groups of patients after a month of daily insulin treatment dosage visceral fat group more than fatty liver group, subcutaneous fat groups, the difference was statistically significant, that again visceral fat increase insulin resistance level is the most obvious. |
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