Study of insulin resistance and first-phase insulin secretion of β-cells in obese children with different levels of glucose tolerance / 中华实用儿科临床杂志

ABSTRACT

Objective To investigate insulin resistance and first-phase insulin secretion among the obese children with normal glucose tolerance,impaired glucose tolerance (IGT) and type 2 diabetes mellitus(T2DM) and to further explore their effects on children with T2DM.Methods Both physical examination and oral glucose tolerance test (OGTT) were performed to determine the glucose tolerance levels on a total of 87 subjects.They were divided into normal glucose tolerance group,IGT group and T2DM group according to their glucose tolerance levels.Insulin resistance and insulin secretion were represented by insulin sensitivity index (IAI) and △ I30/△ G30 =(I30min-I0min) /(G30 min-G0 min),respectively.SPSS software version 10.0 was used for statistical analysis.Differences from the groups were assessed by performing One-way ANOVA,and P ＜ 0.01 was considered significant.Results Among 87 subjects,52 cases turned out to have normal glucose tolerance (normal glucose tolerance group),16 cases were with IGT (IGT group) and 19 cases were with T2DM (T2DM group),respectively.The groups of normal glucose tolerance,IGT and T2DM were found to have the IAI values of-4.36 ±0.79,-4.80 ±0.56 and-4.73 ±0.53,respectively,which indicated that the IAI value of normal glucose tolerance group was significantly higher than those in both IGT and T2DMgroups(F =5.28,P ＜ 0.01),while there was no significant difference between the 2 groups of IGT and T2DM.The △I30/△G30 values of the obesity,IGT and T2DM groups were also indicated as 57.02-± 30.20,28.19 ± 23.47 and 11.65 ± 7.50,respectively,and therefore it could be revealed that the △ I30/△ G30 value of the IGT and T2DM groups were both significantly lower than that of the normal glucose tolerance group (F =47.90,P ＜ 0.01).Conclusions Both insulin sensitivity and first-phase insulin secretion respectively show statistically significant decrease in IGT andT2DM groups compared with those in obesity group,which indicates that they both may play important roles in diabetes onset in children.