目的 探讨三酰甘油(TG)水平对糖耐量正常的2型糖尿病(T2DM)家系一级亲属代谢状况的影响,从而为糖尿病高危人群的防治提供依据.方法 将497例糖耐量正常的T2DM家系一级亲属,按照TG四分位数水平,将其分为4组:TG1组(TG＜0.77 mmol/L)、TG2组(0.77≤TG＜1.06 mmol/L)、TG3组(1.06≤TG＜1.58 mmol/L)和TG4组(TG≥1.58 mmol/L).计算葡萄糖曲线下面积(AUC-G),采用稳态模型的胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗程度,采用稳态模型的胰岛素分泌指数(HOMA-β)和糖负荷后30 min胰岛素增值(△I30)与葡萄糖增值(△G30)的比值来评估胰岛β细胞功能.结果 TG4组受试者AUC-G、HOMA-IR和HOMA-β均显著高于TG1组,差异有统计学意义(P＜0.05).从TG1组到TG3组,△I30/△G30逐渐增高,组间两两比较差异有统计学意义(P＜0.05),而TG4组△I30/△G30出现下降趋势.多元逐步回归分析显示,TG、低密度脂蛋白(LDL)及△I30/△G30是影响血糖的主要因素(P＜0.05).结论 随着TG水平增高,糖耐量正常的T2DM家系一级亲属胰岛素抵抗逐步加重,机体代偿性分泌胰岛素使血糖维持在正常范围,但最终出现胰岛早期分泌功能的下降.%To evaluate the effects of triglycerides on the metabolism of first - degree relatives of type 2 diabetes pedigree with normal glucose tolerance in order to provide evidence for the prevention and treatment of diabetes. Methods According to the level of serum triglyceride, 497 first - degree relatives of type 2 diabetes pedigree with normal glucose tolerance were divided into four groups, including group TGI ( TG < 0. 77 mmol/L), group TG2 ( 0. 77 ≤TG≤1. 06 mmol/L), group TG3 ( 1.06≤TG<1.58 mmol/L) and group TCA ( TG≥ 1.58 mmol/L) . AUC - G was calculated and HOMA-IR was used to evaluate the degree of insulin resistance. HOMA - p and the value of AI30/AG30 were used to evaluate beta cell function. Results Compared with group TGI , the levels of AUC - G, HOMA - IR and HOMA - p in group TCA were significantly higher ( P<0. 05 ) . From group TGI to group TG3, the value of AI30/AG30 gradually increased, and the differences were statistically significant pairwise ( P <(). 05 ) . However, the value of AI30/AG30 in group T(A decreased. Multiple stepwise regression analysis showed that TG, LDL and the value of △130/△G30 were factors influencing blood glucose( P <0. 05 ) . Conclusion With the increase of the level of TG, the insulin resistance of first - degree relatives of type 2 diabetes pedigrees with normal insulin tolerance becomes more severe. The compensatory insulin secretion of the body can maintain the blood glucose at a normal level, but the early secretive function of pancreas islet will be damaged ultimately.
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