Abstract: Objective To analyze the clinical characteristic,pancreatic islet function and concomitant diseases in middle-aged and elderly male hyperinsulinemia patients. Methods Assessed by plasma insulin readouts, middle-aged and elderly male in Beijing were divided into 4 groups: fasting hyperinsulinemia (fasting HINS), two hours afterload hyperinsulinemia (afterload HINS), combined damage (fasting/afterload HINS) and non-hyperinsulinemia (non HINS).Then compare metabolic characteristics, insulin resistance and islet β cell secretory function between these groups. Moreover,assessed by oral glucose tolerance test (OGTT), according to ADA 2003 diagnostic criteria, all the subjects were further divided into 3 groups: normal glucose tolerance (NGT), impaired glucose regulation (IGR), newly diagnosis diabetes (NDM).The difference of combined with metabolic syndrome related diseases were evaluated. ResultsA total of 931 middle-aged men enrolled in this study:fasting HINS group (n=22), afterload HINS group (n=109), fasting / afterload HINS group(n=49) and non-HINS group(n=751). 1HbA1_C readout in the fasting/ afterload HINS group was significantly higher than the afterload HINS group(P <0.01),and fasting HINS group in between.2Among the four groups, the fasting/afterload HINS group showed highest HOMA-IR, followed by fasting HINS group, afterload HINS and non HINS group, and there were significant differences among these four groups(F=344.25,P <0.05). 3After corrected by HOMA-IR, HBCI/IR and FBCI/IR readouts of fasting/afterload HINS group were lower than those of non-HINS group significantly(F=5.08,P <0.05).There were no differences in the level of FBCI/IR between afterload HINS group and non-HINS group. 4The metabolic disorders constituent ratio of hyperinsulinemia(HINS)combined with differences IGR patients were significantly higher than the corresponding non-HINS subgroups(P <0.05). Moreover, with the deterioration of glucose regulation, the ratio of metabolic disorders gradually increased. Conclusion 1Fasting and afterload hyperinsulinemia patients showed more severe insulin resistance, pancreatic islet function was significantly impaired, and glucose metabolism disorder gets deterioration.2Fasting insulin is recommended indicators of hyperinsulinemia in large-scale clinical screening.3Hyperinsulinemia was easier to combine with a variety of metabolic disorders, especially fasting and afterload hyperinsulinemia patients need comprehensive intervention.

Key words: impaired glucose regulation, hyperinsulinemia, insulin resistance, pancreatic islet function