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社区成年人群静息代谢率与胰岛β细胞功能的相关性
作者:耿厚法1  臧秀1  吴婷婷2  刘学奎1  梁军1 
单位:1. 徐州市中心医院 内分泌科, 江苏 徐州 221009;
2. 徐州医科大学 临床学院, 江苏 徐州 221000
关键词:静息代谢率 胰岛素抵抗指数 胰岛β功能指数 胰岛素敏感指数 血糖 
分类号:R589;R587.1
出版年·卷·期(页码):2020·48·第九期(1136-1142)
摘要:

目的:研究社区成年人群中静息代谢率(RMR)的代谢特征,并探讨其与胰岛β细胞功能的关系。方法:根据Mifflin-St Jeor制定的静息代谢公式计算出静息代谢率,按照四分位间距分为4组。采用一般线性方程分析Mifflin-RMR与稳态模型评估(HOMA)指数的相关性,同时分析各代谢指标与Mifflin-RMR的交互作用对HOMA指数的影响。结果:(1)按Mifflin-RMR分层分析显示,随着RMR水平的增加,年龄、高密度脂蛋白胆固醇(HDL)、胰岛素敏感指数(HOMA-IS)指标下降;而胰岛素抵抗指数(HOMA-IR)、胰岛β功能指数(HOMA-β)、空腹血糖(FBG)、空腹胰岛素(FINS)、2 h血糖(OGTT)、体重指数(BMI)、舒张压(DBP)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL)等指标随着RMR的水平增加而增加,其趋势均存在统计学意义。(2)校正性别、年龄和BMI的条件下,HOMA-IR、HOMA-β均随着RMR指标的增加而增加,而HOMA-IS则随着RMR指标的增加而下降;(3)按是否为高血压状态分析显示,在非高血压人群中,HOMA-IS随着RMR的增大而下降,而高血压人群中这种趋势却不明显;进一步交互作用分析显示,高血压人群中的下降趋势无统计学差异,非高血压人群中的下降幅度更明显且差异有统计学。(4)按是否肥胖状态分析显示,无论是否肥胖,RMR均影响HOMA-IS的水平,均有统计学意义。结论:Miffin-RMR与HOMA-IS、HOMA-IR、HOMA-β相关性是独立存在的;Miffin-RMR可作为胰岛素抵抗的预测因子,为探索肥胖、代谢综合征(MetS)和2型糖尿病(T2DM)新的预防和治疗策略提供依据。

Objective: To study the metabolic characteristics of resting metabolic rate (RMR) in community adults and to explore its relationship with the function of islet β cells.Methods: RMR was calculated with the Mifflin-formula developed by Mifflin-St Jeor anddata were divided into quartiles. We not only analyzed the correlation between Mifflin-RMR and HOMA indexes, but also the influence of the interaction between metabolic indicators and Mifflin-RMR onHOMA indexes.Results: According to the Mifflin-RMR hierarchical analysis, age, HDL and HOMA-IS indicators decreased with the increase of RMR level, while the indicators such as HOMA-IR, HOMA-β, FBG, Fins, OGTT, BMI, DBP and TG increased with the increase of RMR level, and the trend was statistically significant. After adjusting for gender, HOMA-IR and HOMA-β increased along with the increase of RMR, while HOMA-IS decreased with the increase of RMR. Analysis of hypertension status showed that HOMA-IS decreased significantly with the increase of RMR in the non-hypertensive population, but this trend was not obvious in the hypertensive population. Further interaction analysis showed that there was no statistically significant difference in the trend of decline in the hypertensive population, while the decline was more pronounced in the non-hypertensive population.It showed that RMR affected the level of HOMA-IS, which was not disturbed byobesity status, the difference being statistically significant.Conclusion: The correlation of Miffin-RMR with HOMA-IS,HOMA-IR and HOMA-β is independent. Miffin-RMR might be used as a predictor of insulin resistance, which provides new strategies for the prevention and treatment of obesity, metabolic syndrome and type 2 diabetes mellitus.

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