【摘要】 目的 研究早期2型糖尿病(T2D)患者的胰岛素敏感性和B细胞分泌功能，以探讨肥胖对T2D患者胰岛素抵抗(IR)和胰岛素分泌功能的影响。方法 分别检测118例(其中正常对照组20例，单纯肥胖组18例，肥胖T2D组48例，非肥胖T2D组32例)身高、体重、腰围、臀围、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹血糖(FPG)、空腹胰岛素(FINS)，并计算体重指数(BMI)、腰臀比(WHR)、胰岛素抵抗指数(HOMA-IR)、B细胞功能指数(HOMA-IS)。 结果 与正常对照组比较，单纯肥胖组和两组T2D组的HOMA-IR明显增高，而肥胖T2D组HOMA-IR较非肥胖T2D组更高(P均<0.01)。与正常对照组比较，两组T2D组的HOMA-IS明显降低(P<0.01)，但肥胖与非肥胖T2D组间无明显差异。HOMA-IR与BMI和FPG呈明显正相关(校正r2=0.726，P<0.01)。 结论 与非肥胖T2D患者比较，肥胖T2D患者具有更明显的胰岛素抵抗。肥胖是IR的重要因素，而IR是发生T2D的起始原因。

    【关键词】 肥胖； 2型糖尿病； 胰岛素抵抗； B细胞功能

    Effects of obesity on insulin resistance and β-cell function in type 2 diabetic subjects

    GONG Jing, YE Lin, GUO Yu-yu, et al.

    Department of Endocrinology,The Ninth People’s Affiliated Hospital,Jiao Tong University ,Shanghai 200011，China

    【Abstract】 Objective To study insulin sensitivity and insulin secretion of β-cells in early type 2 diabetes(T2D) for further exploring the effects of obesity on insulin resistance and insulin secretion in T2D subjects. Methods Height,body weight,waist circumference,hip,systolic blood pressure(SBP),diastolic blood pressure(DBP),triglyceride(TG),total cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL),fasting plasma glucose(FPG),fasting insulin(FINS) were measured in 118 subjects,including 20 normal controls, 18 simple obese subjects,48 obese subjects with T2D and 32 non-obese subjects with T2D.Body mass index(BMI),waist to hip ratio(WHR),insulin resistance index(HOMA-IR) and β-cell function index (HOMA-IS) were calculated. Results Compared with normal controls,the value of HOMA-IR was significantly increased in simple obese group and both T2D groups,and the HOMA-IR in obese group with T2D was even much higher than that in non-obese group(all P<0.01).Compared with normal controls, the value of HOMA-IS was significantly decreased in both T2D groups,but there was no significant difference between obese and non-obese groups with T2D.HOMA-IR was positively correlated with BMI and FPG (adjusted r2=0.961,P<0.01). Conclusion Compared with non-obese subjects with T2D,the obese subjects with T2D have more severe insulin resistance.Obesity was the important fact of insulin resistance which was the first cause of T2D. ......