Study On The Correlation Between Postprandial Blood Lipid Level And Insulin Resistance In Oral Fat Tolerance Test

Objective: To investigate the effect of early lipid metabolism disorders on insulin resistance,and to provide a new method for the prevention and treatment of insulin resistance by analyzing the correlation between changes in serum triglyceride levels and insulin resistance in healthy people with oral fat tolerance test.Methods: Health check-up volunteers were recruited from Endocrinology Department of the Hebei General Hospital.Subjects were routinely examined for general information including height,weight,blood pressure,hematuria routine,biochemical items,ultrasound,etc..Oral glucose tolerance test to exclude diabetes patient.After excluding those who did not meet the inclusion criteria and those with extreme values,a total of 502 volunteers participated in the study.The index Homeostasis model assessment of insulin resistance(HOMA-IR)was used to evaluate an individual's insulin resistance(IR)level.According to the HOMA-IR level,we divided all subjects into control group(Con,HOMA-IR < 2.70,295 cases)and IR group(IR,HOMA-IR ? 2.70,207 cases).The study subjects underwent an oral high-fat meal load test,and venous blood was collected at 0h,2h,4h,6h,8h,and 10 h before and after the oral high-fat meal;blood lipid levels were measured respectively at each time point.All data were collated and statistically analyzed using Microsoft Excel 2016,SPSS22.0 and Med Calc15.2 software.Results: 1.There was no significant difference in age and gender between the insulin resistance group and the control group(P > 0.05);Compared with the Con group,levels of BMI,WC,systolic blood pressure,diastolic blood pressure,fasting blood glucose,insulin,TG,Apo B,and UA were significantly increased in IR group,while the levels of Apo A1 and HDL-C were significantly reduced in IR group(P <0.05).2.A logistic regression analysis showed that SBP,DBP,BMI,WC,fasting TC,TG,LDL-C,Apo B and uric acid were risk factors of insulin resistance(P <0.05),while HDL-C and Apo A1 were protective factors(P <0.001).3.Serum lipid metabolism levels at different time points after high-fat meals in two groups were analyzed with repeated measurement analysis of variance.It showed that after high-fat meals in two groups,TG levels were significantly different at different time points(P <0.001).TG levels were significantly different between the two groups(P <0.001);there was no interaction between time and groups(P = 0.154).TG reached peak in IR group 6h after high-fat meal(3.82 mmol / L),while TG reached peak in Con group 4h after high-fat meal(2.63 mmol / L).4.With ROC curve,postprandial triglyceride levels at different time points were used to predict the incidence of insulin resistance.The results show that the AUC of PTG2(0.734,95% CI = 0.691-0.778,P < 0.001)is greater than other postprandial time points.At the same time,the Yoden index(0.364)corresponding to PTG2 is also higher than those in other time points,and the cutoff point corresponding to this time point is 2.47 mmol / L.5.After adjusting the relevant risk factors,the risk of insulin resistance increased by 1.893 times(95% CI = 1.335-2.684,P <0.001)for each unit of triglyceride level 2h postprandially,and triglyceride levels at 4h after high-fat meal were not associated with the risk of insulin resistance(OR = 1.179,95% CI = 0.957-1.451,P = 0.122).6.Compare the PTG intercept point of this study with the PTG intercept point of the same study abroad.The results show that the PTG cut-off point in this study(PTG2h 2.47 mmol / L)has a stronger ability to predict the risk of insulin resistance(sensitivity = 60.5%,specificity = 73.7%,Yoden index = 0.342),and the inferred IR The highest incidence(62.8%).7.According to the fasting triglyceride levels of the subjects and the post-prandial triglyceride cutoff points obtained in this study,the subjects were divided into normal fat tolerance group(NFT),impaired fat tolerance group(IFT)and fasting high triglyceride group(FHTG).The gender,age,BMI,WC,SBP,DBP,fasting TC,TG?HDL-C?LDL-C?Apo A,Apo B1?FBG?FGI ? HOMA-IR and prevalence of insulin resistance in different lipid tolerance groups were statistically different(P < 0.05).Among three groups,BMI,WC,TG,LDL-C and Apo B1 showed a significant increasing trend with impaired lipid tolerance,and the differences among groups were statistically significant(P < 0.05).HDL-C between the three groups showed a significant decreasing trend with impaired lipid tolerance,and the differences between groups were statistically significant(P < 0.05).Among the three groups,FBG,FGI,and HOMA-IR showed a significant upward trend with the degree of impaired lipid tolerance,and the differences between the groups were statistically significant(P < 0.05).As the degree of impaired lipid tolerance aggravated,the incidence of IR in the three groups was 33.2%,45.5%,and 64.7%,and differences between groups were statistically significant(P < 0.05).Conclusion: 1.Triglyceride levels after a oral fat tolerance test test are positively correlated with insulin resistance.2.The study indicate that 2h TG ? 2.47 mmol / L after a high-fat load meal can be the cutoff value for an individual with a normal fasting TG level but with lipid disorder.The value can be an early index for the prediction of IR.3.Oral fat tolerance test is valuable for the screening of individuals with early lipid metabolism disorders while with normal fasting lipid levels.