| Insulin resistance(IR)caused by glucose and lipid metabolism disorder is the pathological basis of diseases such as cardiocerebral vascular diseases and diabetes.Clinical workers analyze glycolipid metabolism in vivo through changes in fasting blood glucose and blood fat.But the body is in a postprandial state for most of the day.There are many studies on fasting lipid levels in clinical works,but few studies on the clinical significance of postprandial blood lipid changes.Objectives: This research was conducted to study alteration of blood lipid and inflammatory cytokines TNF-αand IL-6 after high-fat meal test to find new ways for early prevention and treatment of diabetes and vascular complications.Methods: In our hospital’s outpatient clinic,we recruited volunteers who aged between 25 and 65 years old.They finished the questionnaire and unified physical examination in the physical examination center.The outpatients with diseases which affect lipid metabolism must be excluded.According to the results of glucose tolerance test,people were divided into normal glucose tolerance group(NGT)58,impaired glucose regulation group(IGR)60,and type 2 diabetes mellitus group(T2DM)62.All subjects were given a standard diet for one week,and a high-fat meal(total calories 1500 kcal,fat 60%,carbohydrate 20%,protein 20%)after a 8-hour overnight fast.The meal was completed within 10 minutes.Then they were required to fast for 10 hours,with free access to water but not tea,beverage,etc.They were also prohibited from smoking and doing strenuous exercise.Elbow vein blood was obtained to meature test-related indicators at fasting and 2,4,6,8,10 hafter high-fat meal.FFA,TNF-αand IL-6 were detected by kit method,and the other indexes were tested in the laboratory of our hospital.Experimental results were analyzed by SPSS21.0 software.Results: 1.There was no statistical difference in gender and age between the three groups(P>0.05).The weight,BMI,waist circumference,systolic blood pressure,and diastolic blood pressure of the three groups all increased with the extent of impaired glucose tolerance.There was a statistically significant difference between the three groups(P<0.01).The fasting plasma TC,fasting plasma LDL-C and fasting Apo B had no statistical difference between the three groups(P>0.05).But they all increased with the extent of impaired glucose tolerance.The fasting plasma HDL-C and fasting plasma Apo A1 had statistical difference between the three groups(P<0.05),and they decreased with the extentof impaired glucose tolerance.The fasting plasma TG and fasting plasma FFA had statistical difference between the three groups(P<0.01),and they decreased with the extent of impaired glucose tolerance.Fasting plasma glucose,fasting plasma insulin,and HOMA-IR had statistical difference among the three groups(P<0.01),and they all increased with the extent of impaired glucose tolerance.2.The plasma TG levels of the three groups all increased after high-fat meal,reaching the peak at 4h、6h、6h after meal respectively.Only the plasma TG level of NGT group at postprandial 10 h was closer to their fasting TG level,and the plasma TG levels of IGR group and T2 DM group at postprandial 10 h were significantly higher than the fasting plasma TG levels in the two groups.The results of repeated measures ANOVA showed that there was a significant difference in plasma TG levels at different time after high-fat meal(F=69.188,P<0.01);There was a significant difference in plasma TG levels between the three groups(F=6.118,P<0.01).There was no interaction between time and groups(F=1.873,P=0.079).3.The plasma FFA levels of the three groups all increased after high-fat meal,with the peaking time at postprandial 6h、8h、8h respectively,and plasma FFA levels at postprandial 10 h were all still higher than their fasting FFA levels.The results of repeated measures ANOVA showed that there was a significant difference in plasma FFA levels at different time after the high-fat meal(F=20.919,P<0.01);there was a significant difference in plasma FFA levels between the three groups(F=7.541,P<0.01);there was no interaction between time and groups(F=1.384,P=0.226).4.The fasting plasma TNF-αlevels in the three groups increased with the extent of impaired glucose tolerance,and there was a statistically significant difference between the three groups(P<0.05).After a high-fat meal,the plasma TNF-αlevels all increased in the three groups.The plasma TNF-αlevels in the NGT group was higher than the fasting plasma TNF-αlevels at 10 h after the meal(P<0.01),while the plasma TNF-αlevels at 4 h after the meal in the IGR group and the T2 DM group were higher than the fasting plasma TNF-αlevels in the two groups(P<0.01).The results of repeated measures ANOVA showed that there was a significant difference in plasma TNF-αlevels at different time after high-fat diet(F=107.422,P<0.01);there was a significant difference in plasma TNF-αlevels between the three groups(F= 69.76,P<0.01);there was a interaction between time and groups(F= 14.402,P<0.01).The levels of fasting plasma IL-6 in the three groups increased with the extent of impaired glucose tolerance.There was a statistically significant difference between the three groups(P<0.01).After a high-fat meal,the plasma IL-6 levels all increased in the three groups.The results of repeated measures ANOVA showed that there was a significant difference in plasma IL-6 levels at different time after high-fat diet(F=257.879,P<0.01);there was a significant difference in plasma IL-6 levels among the three groups(F=383.906,P<0.01);there was a interaction between time and groups(F=17.801,P<0.01).Conclusions: 1.The high-fat meal load test of different glucose tolerance groups showed that pre-diabetes patients not only had reduced glucose tolerance,but also had reduced tolerance of fatty acids.2.The change of plasma lipids in impaired glucose tolerance after high-fat meal was characterized by the higher and delayed peak of postprandial TG and FFA.3.The levels of postprandial TNF-α and IL-6 showed obvious fluctuations in impaired glucose tolerance and T2DM. |
