GUO Qing-yan,ZHU Cui-ling,BU Le,et al.Pancreatic beta-cell function and insulin resistance in type 2 diabetic patients with different body mass indexes[J].同济大学学报（医学版）,2018,39(1):83-88. [点击复制]
(Tongji University School of Medicine, Shanghai 200092, China;Dept. of Endocrinology and Metabolism-National metabolic Managment Center, Tenth Peoples Hospital, Tongji University, Shanghai 200072, China)
Abstract:
Objective To investigate the pancreatic β-cell function and insulin resistance in T2DM patients with different BMI. Methods The patients were divided into 4 groups: normal BMI group(18.5≤ BMI＜24, n=132), overweight group(24≤BMI＜28, n=142), mild obese group(28≤BMI＜30, n=38) and severe obese group(BMI≥30, n=65). There were 157 patients with diabetes duration＜5 years, 90 cases with duration of 5-10 years and 110 patients with duration >10 years. Lipid profile, FPG, FINS, HbA1c and insulin
levels were measured; IS, HOMA-IR, AUCGlu, AUCINS, ΔI30/ΔG30, and DI were calculated to evaluate the insulin resistance and beta-cell secretion function. Results The age, FINS, HOMA-IR, AUCINS, DI, and ΔI30/ΔG30 in severe obesity group were significantly higher than those in normal BMI, overweight, and mild obesity groups(P＜0.001), while IS and HbA1c levels were lower significantly(P＜0.01). Patients in mild and severe obese group had significantly higher TG levels compared to normal BMI group, while there was no significant difference between mild and severe obese groups(P>0.05). There were no statistical significances in TC, HDL-C, LDL-C, FPG, and AUCGlu among different BMI subgroups(P>0.05). Patients with diabetic duration >10 years had significantly lower BMI, AUCINS, DI, and ΔI30/ΔG30 than those with duration＜5 years and 5-10 years (P＜0.001), while there were no significant differences in FPG, FINS, HOMA-IR, IS and AUCGlu among the three groups. After adjustment for sex, age, duration of diabetes and HbA1c, the FINS, HOMA-IR, AUCINS, DI, and ΔI30/ΔG30 in severe obesity group significantly increased and IS levels significantly decreased compared to the other three groups (P＜0.001). Moreover, there were significant differences in TG and HDL-C levels, but not in TC, LDL-C, FPG and AUCGlu among the four groups. Correlation analysis showed that BMI was positively correlated with TG, FINS, HOMA-IR, AUCINS, DI and ΔI30/ΔG30 and negatively correlated with IS andHbA1c; while not correlated with TC, LDL-C, HDL-C, FPG and AUCGlu. Conclusion The insulin secretion and pancreatic β-cell function are decreased gradually with the increase of duration of diabetes. In patients with T2DM, the insulin sensitivity is decreased and insulin resistance is increased significantly, as well as functional compensation and insulin secretion is enhanced remarkably with the rising BMI.
