›› 2011, Vol. 31 ›› Issue (11): 1603-.doi: 10.3969/j.issn.1674-8115.2011.11.021

• Original article (Clinical research) • Previous Articles     Next Articles

Clinical features and 2-year outcomes of patients with impaired glucose regulation

WANG Shen-qi1,2, CHEN Hui-fen3, HOU Xu-hong1, SHEN Chu3, LU Hui-juan1, PAN Zhi-jian1, JIA Wei-ping1   

  1. 1.Department of Endocrinology and Metabolism, the Sixth People's Hospital, Shanghai Jiaotong University, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai 200233, China；2.Liuyuan School of Clinical Medicine, Shanghai Jiaotong University, Shanghai 200233, China；3.Shanghai Jiading District Anting Community Health Service Center, Shanghai 201805, China
  • Online:2011-11-28 Published:2011-11-29
  • Supported by:

    Shanghai Science and Technology Committee Foundation, 08dj1400601, 09DZ1950202；Shanghai Jiading District Health Bureau Foundation, KYXM2008-1112

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Abstract:

Objective To evaluate the insulin secretion and sensitivity in patients with different subtypes of impaired glucose regulation (IGR), and investigate the 2-year outcomes of glucose tolerance. Methods Ninety-two patients with IGR were followed up for 2 years. At baseline and during follow-up, 75 g oral glucose tolerance tests (OGTT) were performed. β cell function index of homeostasis model assessment (HOMA-β) and β cell secretion function (BCF) index (first-phase BCF, BCF-Ⅰ; second-phase BCF, BCF-Ⅱ) of homeostasis model assessment were employed to evaluate insulin secretion, insulin resistance index of homeostasis model assessment (HOMA-IR) was adopted to determine hepatic insulin sensitivity, and  insulin sensitivity index(ISI) was used to assess peripheral insulin sensitivity. Results According to baseline OGTT findings, 92 patients with IGR were divided into isolatedimpaired fasting glucose group (I-IFG group, n=16), isolated-impaired glucose tolerance group (I-IGT group, n=66) and complex glucose intolerance group (CGI group, n=10). There was no significant difference in age, gender, overweight/obesity, blood pressure and lipids among groups (P＞0.05). At baseline, HOMA-IR declined in the order of CGI group, I-IFG group and I-IGT group, ISI increased in the order of CGI group, I-IGT group and I-IFG group, and BCF-Ⅰincreased in the order of I-IFG group, CGI group and I-IGT group, with significant differences among groups (P<0.05 for all). During the follow-up for 2 years, 20 patients with IGF developed into diabetes mellitus, with the cumulative incidence of 21.7%. Conclusion IGT is the main form of IGR. Impairment of first-phase secretion of β cell is most significant in I-IFG population. CGI population has the most serious hepatic and peripheral insulin resistance. I-IFG population has more serious hepatic insulin resistance than I-IGT population, and that is opposite for peripheral insulin resistance.

Key words: glucose tolerance, diabetes, impaired glucose regulation, insulin resistance, outcome