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非胰岛素依赖型糖尿病(NIDDM)的特征是既有胰岛素抵抗,又有β-细胞功能不全。哪种损害在先,为主,目前尚有争论。本文调查了糖耐量正常1,459名比马印第安人,年龄15岁以上,平均35岁。随访长达16.3年,平均6.9年。随访中306人出现糖耐量损害,其中54人发展为NIDDM,170人继续有糖耐量损害,75人糖耐量恢复正常,7人无进一步随访。其余1,153人中1,032人糖耐量仍正常,121人发展为NIDDM。最后一次检查时,1,107人糖耐量正常,糖耐量损害者177人,175人患糖尿病。从机率函数分析表明,糖耐量从正常向损害恶化的预报征是年龄(平方)、体重指数、餐后2小时血糖和空腹血清胰岛素较高。后二个变量可代以空腹血糖和餐后2小时胰岛素。这二个均与进展为糖耐量损害程度呈正相关。胰岛素抵抗先于糖耐量损害,并对糖耐量的恶化起主要作用。高胰岛素血症反映胰岛素抵抗,是一种早期的异常,注定病人将发生糖耐量损害或NID-DM。比马人的糖耐量从正常转为损害,即使体重不增加,空腹及餐后2小时胰岛素均进一步增加。这种转
Non-insulin-dependent diabetes mellitus (NIDDM) is characterized by both insulin resistance and beta-cell dysfunction. What kind of damage in the first, the main, there is still controversy. This article investigates 1,459 Pima Indians with normal glucose tolerance, aged 15 and over, averaging 35 years. Followed up for 16.3 years, an average of 6.9 years. During the follow-up, 306 patients suffered from impaired glucose tolerance, of whom 54 developed NIDDM, 170 continued to have impaired glucose tolerance, 75 had normal glucose tolerance and 7 had no further follow-up. Of the remaining 1,153 people, 1,032 had impaired glucose tolerance and 121 developed NIDDM. At the last examination, 1,107 people had normal glucose tolerance, 177 had impaired glucose tolerance, and 175 had diabetes. From the probability function analysis showed that, from the normal to impaired glucose tolerance prediction of predisposing signs of age (square), body mass index, 2 hours postprandial blood glucose and fasting serum insulin higher. The latter two variables can be substituted for fasting blood glucose and 2 hours postprandial insulin. Both of these are positively correlated with the progression to impaired glucose tolerance. Insulin resistance precedes impaired glucose tolerance and plays a major role in the worsening of glucose tolerance. Hyperinsulinemia reflects insulin resistance, an early abnormality that is destined to cause impaired glucose tolerance or NID-DM in patients. The horse’s glucose tolerance shifted from normal to impaired, with no increase in body weight, both fasting and postprandial insulin for 2 hours. This turn