摘要
目的比较不同糖化血红蛋白(HbA1c)水平、不同病程的2型糖尿病患者胰岛β细胞功能的差异。方法2014年12月~2016年4月于南京医科大学第一附属医院内分泌科住院的803例2型糖尿病患者作为研究对象,测定人体参数、生化指标、胰岛自身抗体,并行馒头餐试验评估患者的胰岛β细胞功能及胰岛素抵抗。结果二者线性相关分析发现2型糖尿病患者HbA1c与HOMA2-IR、HOMA2-%β、DI30、DI180均呈负相关(P=0.000),病程与HOMA2-IR、HOMA2-%β、DI180均呈负相关(P<0.05)。将患者依据HbA1c水平分为3组,3组间HOMA2-IR、HOMA2-%β、DI30和DI180均有统计学差异(P=0.000),低HbA1c水平组(HbA1c≤7.8%)患者HOMA2-%β、DI30、DI180明显高于其他2组,而高HbA1c水平组(HbA1c>9.8%)HOMA2-%β明显下降。将患者按病程分为3组,协方差分析显示3组间HOMA2-IR、HOMA2-%β、DI30、DI180均有统计学差异(P=0.000),随着病程延长,DI30、DI180逐步下降。多元线性回归分析显示,HbA1c、糖尿病病程和体质量指数是2型糖尿病胰岛β细胞功能的独立影响因素。结论随着HbA1c水平的升高或病程的延长,2型糖尿病患者胰岛β细胞分泌功能均逐渐下降。HbA1c明显升高时,患者胰岛β细胞分泌功能明显下降,而病程明显延长时,患者胰岛β细胞分泌功能并未急速下降。
Objective To compare islet β-cell function in type 2 diabetic (T2DM) patients with different glycosylated hemoglobin (HbA1c) levels and diabetes durations.MethodsWe examined body parameters,biochemical profiles and islet autoantibodies in a total of 803 T2DM patients admitted in the Department of Endocrinology of the First Affiliated Hospital of Nanjing Medical University between December,2014 andApril,2016.The patients were stratified by HbA1c level and disease course and underwent steamed bun test to evaluate islet β-cell function and insulin resistance.Results Linear correlation analysis showed that in T2DM patients,HbA1c level was negatively correlated with HOMA2-IR,HOMA2-%β,DI30 and DI180 (P=0.000),and disease course was negatively correlated with HOMA2-IR,HOMA2-%β,and DI180 (P<0.05).The patients with different HbA1c levels showed significantly different HOMA2-IR,HOMA2-%β,DI30 and DI180 (P=0.000);HOMA2-%β,DI30 and DI180 were significantly higher in patients with HbA1c levels <7.8%,and HOMA2-%β was significantly decreased in patients with HbA1c levels above 9.8%.The patients with different disease courses also had significant differences in HOMA2-IR,HOMA2-%β,DI30,and DI180 (P=0.000),and as the disease course extended,DI30 and DI180 tended to decrease progressively.Multivariate linear regression analysis showed that HbA1c,diabetes duration,and body mass index (BMI) were all independent factors affecting islet β- cell function in T2DM patients.Conclusion The secretion function of islet β cells decreases progressivelywith the increase ofHbA1c level or disease course in T2DMpatients,but the disease course does not appear to have an effect as strong as that ofHbA1c level on islet β cell function.
作者
何银辉
徐海燕
付麒
杨涛
HE Yinhui;XU Haiyan;FU Qi;YANG Tao(Department of Endocrinology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Department of Endocrinology,Lishui Municipal Central Hospital,Lishui 323000,China)
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2019年第9期1003-1008,共6页
Journal of Southern Medical University
基金
Supported by National Natural Science Foundation of China(81530026)~~
关键词
2型糖尿病
Β细胞功能
胰岛
糖化血红蛋白
病程
type 2 diabetes mellitus
β-cell function
islet
glycosyated hemoglobin
disease course
