摘要
目的 通过比较肥胖和银屑病患者的糖代谢及生化等指标,揭示2型糖尿病合并银屑病或肥胖对胰岛素抵抗、胰腺功能的影响。方法 对2016年1月—2019年5月于上海市浦东医院住院部内分泌科的2型糖尿病及合并肥胖或银屑病患者的系统病历信息进行回顾性分析,比较2型糖尿病合并肥胖(obesity,OB)(n=15)与2型糖尿病合并银屑病(psoriasis,PsO)(n=19)及普通2型糖尿病(type 2 diabetes mellitus,T2DM)(n=79)患者糖化血红蛋白(HbA1c)、空腹血糖(FPG)及餐后2 h血糖(2 hPG)、空腹C肽(FC-P),餐后2 hC肽(2 hC-P)、血脂、尿微量白蛋白、肾小球滤过率(eGFR)、血肌酐(SCr)、血尿素氮(BUN)、稳态模型胰岛素抵抗指数(HOMA-IR)、稳态模型胰岛素胰岛β细胞功能指数(HOMA-β)以3组患者糖代谢及并发症情况。结果 病程上,PsO较OB与T2D组稍短,但差异无统计学意义(P>0.05);3组患者平均BMI、FPG、PPG、C肽、FPCP、PPCP、HbA1c均差异无统计学意义(P>0.05)、HOMA-IR显示OB组与PsO组较T2DM组增高,但差异无统计学意义(P>0.05);HOMA-β显示PsO组较OB组、T2DM组增高,但差异无统计学意义(P>0.05);3组患者eGFR、SCr、BUN对比,差异无统计学意义(P>0.05);OB组与PsO组患者较T2DM组患者HOMA-IR增高,而PsO组患者HOMA-β指数较OB组与T2DM组患者稍高,差异有统计学意义(P<0.05)。结论 在PsO相对早期,PsO患者具有相对保留的胰腺功能;与OB、T2DM相比肾脏微血管病变相对较轻;而单纯OB与PsO患者具有相当的胰岛素抵抗作用,而PsO胰腺功能相对保留。
Objective Compared the glucose metabolism and biochemical indicators of obesity and psoriasis patients,reveal the effects of type 2 diabetes mellitus combined with psoriasis or obesity on insulin resistance and pancreatic function.Methods From January 2016 to May 2019,the medical record system information of patients with type 2 diabetes mellitus and patients with obesity or psoriasis who went to the Endocrinology Department of the inpatient department of Shanghai Pudong Hospital was retrospectively analyzed.Compared glycated hemoglobin(HbA1c),fasting blood glucose(FPG),2-hour postprandial blood glucose(2 hPG),fasting C-peptide(FC-P),2-hour postprandial Cpeptide(2 hC-P),blood lipids,urine microalbumin,serum creatinine(SCr),blood urea nitrogen(BUN),homeostasis model insulin resistance index(HOMA-IR),homeostasis model insulin beta cell function index(HOMA-beta) in patients with type 2 diabetes mellitus with obesity(OB)(n=15),type 2 diabetes mellitus with psoriasis(PsO)(n=19) and common type 2 diabetes mellitus(T2DM)(n=79).The glucose metabolism and complications of the three groups were evaluated.Results In terms of disease course,PsO was slightly shorter than that of OB and T2D groups,but the difference was not statistically significant(P>0.05),HOMA-IR showed that the OB group and the PsO group were higher than the T2DM group,but the difference was not statistically significant(P>0.05);HOMA-β showed that the PsO group was higher than the OB group and the T2DM group,but the difference was not statistically significant(P>0.05).There was no statistically significant difference in eGFR,SCr and BUN among the three groups(P>0.05).OB group and PsO group patients had higher HOMA-IR than T2DM patients,while PsO group patients had slightly higher HOMA-β index than OB group and T2DM group patients,the difference was statistically significant(P<0.05).Conclusion In the relatively early stage of PsO,patients with PsO have relatively preserved pancreatic function.Compared with OB and T2DM,renal microvascular lesions were relat
作者
文松
李彦彦
阮氏琼娥
袁心露
龚敏
王聪聪
徐冬香
周里钢
WEN Song;LI Yanyan;RUAN Shiqiong'e;YUAN Xinlu;GONG Min;WANG Congcong;XU Dongxiang;ZHOU Li-gang(Department of Endocrinology,Pudong Hospital Affiliated to Fudan University(Shanghai Pudong Hospital),Shang-hai,201399 China;Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling,Shanghai,201399 China)
出处
《糖尿病新世界》
2022年第18期5-11,共7页
Diabetes New World Magazine
基金
国家自然科学青年基金(21675034)
上海市浦东医院重点学科(Zdxk2020-11)上海市浦东医院重点专科(Zdxk2020-24)
上海市中西医结合重点专科(ZHYY-ZXYJHZX-2-201712)
浦东新区中西医结合重点专科(PWZzk2017-03)
浦东医院上海市浦东新区临床高原学科项目资助(PWYgy2021-03)
复旦张江临床医学创新基金项目(KP0202118)。
关键词
2型糖尿病
肥胖
银屑病
胰岛素抵抗
胰腺功能
Type 2 diabetes
Obesity
Psoriasis
Insulin resistance
Pancreatic function
