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目的:探索南京市鼓楼区居民胆囊疾病与胰岛素抵抗、胰岛β细胞功能的关系以及胆囊疾病患者的糖尿病发生风险。方法:对南京市鼓楼区8 180例既往无糖尿病的居民进行问卷调查、体格检查、血样采集、口服糖耐量试验(OGTT)及胰岛素释放试验。分析胆囊疾病各组的特征,比较各组胰岛素抵抗与胰岛β细胞功能指标,分析胆囊疾病患者糖尿病风险。结果:性别、年龄、血压、体重指数(BMI)、腰臀比(WHR)、负荷后血糖、糖化血红蛋白(Hb A1c)、血脂、肝酶、生活方式及糖尿病发病率在无胆囊疾病、胆囊疾病未手术及胆囊疾病术后3组的分布不同。2组胆囊疾病患者胰岛素敏感性指标胰岛素抵抗(HOMA-IR)、胰岛素敏感指数(ISI)、胰岛素释放指数(INSR120)与无胆囊疾病者的差异有统计学意义(P<0.05)。胆囊疾病手术后糖尿病及代谢综合征风险增加。结论:胆囊疾病在既往无糖尿病史的南京市鼓楼区居民中是胰岛素抵抗的标志,胆囊疾病术后状态是糖尿病的危险因素。
Objective: To explore the relationship between gallbladder disease and insulin resistance, pancreatic β-cell function and the risk of diabetes in gallbladder patients in Gulou district of Nanjing. Methods: A questionnaire survey, physical examination, blood sampling, oral glucose tolerance test (OGTT) and insulin release test were conducted among 8 180 residents without previous diabetes in Drum Tower District, Nanjing. Analysis of the characteristics of each group of gallbladder disease, insulin resistance and pancreatic β-cell function indicators were compared to analyze the risk of diabetes in patients with gallbladder disease. Results: The prevalences of gender, age, blood pressure, body mass index (BMI), WHR, postload blood glucose, HbA1c, lipids, liver enzymes, lifestyle and diabetes mellitus were higher in patients with no gallbladder disease, gallbladder disease The distribution of the three groups after surgery and gallbladder disease were different. There were significant differences in insulin sensitivity index (HOMA-IR), insulin sensitivity index (ISI), insulin release index (INSR120) and no gallbladder disease among the two groups of patients with gallbladder disease (P <0.05). Gallbladder disease increases the risk of diabetes and metabolic syndrome after surgery. Conclusion: Gallbladder disease is a marker of insulin resistance among residents in Gulou District of Nanjing City, which had no previous history of diabetes mellitus. The postoperative state of gallbladder disease is a risk factor for diabetes mellitus.