The Analysis Of Insulin Resistance And Pancreatic β-cell Function And The Study On Intervention In The Population With Impaired Fasting Glycaemia

Objective To investigate the features of insulin resistance ( IR) andβ-cell function in the population with impaired fasting glycaemia ( IFG) . And then to determine whether Rosiglitazone sodium can be used to increase insulin sensitive and improve glucose tolerance in individuals with impaired fasting glucose on the basis of rational diet and exercise.Methods According to oral 75 g glucose tolerance test (OGTT) ,463 subjects aged≥30years were divided into normal glucose tolerance (NGT) group , IFG group , impaired glucose tolerance ( IGT) group and IFG/ IGT group. Insulin resistance index (HOMA-IR) andβ-cell function index (HBCI) of Homa model , 1-phase and 2-phase insulin release indexes were applied to assess the status of IR andβ-cell function in these groups. Afterwards, the 137 patients with IFG was divided into two groups randomly : Lifestyle intervention group(n=69), the comprehensive strengthening intervention group(n=68).The period of observation was 6 months. The observed items included: the body mass index (BMI),fasting plasma glucose (FPG),postprandial 2 hours plasma glucose (2HPG),total cholesterol(TC),total glycerin(TG),high density lipoprotein cholesterol(HDL-c),low density lipoprotein cholesterol(LDL-c ),fasting insulin(FINS),glycohemoglobin (HbA1c)and so on.Results (1) Compared with NGT group , body mass index (BMI) , waist-to-hip ratio(INS) , fasting plasma insulin(TG) , serum triglyceride (BP), blood pressure and HOMA-IR were higher in IFG group , while the HBCI , 1-phase and 2-phase insulin release indexes were lower( P < 0. 012 P < 0. 001) , HOMA-IR was positively and HBCI , 1-phase and 2-phase insulin release indexes were negatively correlated with development of IFG, the predictable concordance on development of IFG was 0. 66-0. 79 in each logistic regression analysis model (all P < 0. 001) . (2) Compared with IGT group , the OGTT 2h plasma insulin was lower in IFG group ( P < 0. 001) , HOMA-IR , 1-phase and 2-phase insulin release indexes were positively and HBCI was negatively correlated with development of IFG, the predictable concordance on development of IFG was 0. 56-0. 74 in each logistic regression analysis model (all P < 0. 001) . (3)After 6 months treatment, we found FPG,2HPG,TC,TG,LDL-C,FINS,HbA1c were decreased sharply in the comprehensive strengthening intervention group , the difference had statistical significance(P<0.05);while BMI,WHR,TC,TG,LDL-C,FPG,2hPG,FINS,HbA1c were declined very little and there were no statistical significance(P>0.05)in the rational diet and exercise group after 6 month.Conclusion (1)Insulin sensitivity andβ-cell function in fasting status were significantly worse in IFG group than those in both NGT group and IGT group , whereas insulin secretion after glucose load in IFG group was better than that in IGT, although was worse than that in NGT group. IFG may be due to dissociation of IR andβ-cell function during fasting and postprandial periods , suggesting that subjects with IFG are those who suffer from impaired glucose homeostasis but differ from IGT. (2)It is necessary to administer rosiglitazone sodium to the patients with IFG on the basis of rational diet and exercise.