Background Increasingly, evidence from population, clinic-based and laboratory studies supports an independent association between obstructive sleep apnea syndrome （OSAS） and an increased risk of type 2 diabetes; ho...Background Increasingly, evidence from population, clinic-based and laboratory studies supports an independent association between obstructive sleep apnea syndrome （OSAS） and an increased risk of type 2 diabetes; however, this observation has yet to be replicated in China and the potential mechanisms that link these two conditions are not clear. Methods A total of 179 Han Chinese subjects were enrolled in this study. All subjects underwent polysomnography, the oral glucose tolerance-insulin releasing test （OGTT-IRT） and serum HbAlc measurement. Indexes including homeostasis model assessment-IR （HOMA-IR）, Matsuda index, HOMA-β, early phase insulinogenic index （△I30 / △G30）, AUC-I180 and oral disposition index （DIo） were calculated for the assessment of insulin resistance and pancreatic β-cell function. Results Based on OGTT, 25.4%, 44.6% and 54.5% subjects were diagnosed having glucose metabolic disorders respectively in control, mild to moderate and severe OSAS groups （P 〈0.05）. Serum HbA1c levels were highest in subjects with severe OSAS （P 〈0.05）. In contrast, compared with normal subjects, HOMA-β, △I30/△G30 and DIo were lower in severe OSAS group （P 〈0.05）. In stepwise multiple linear regressions, 0-min glucose and HbAlc were positively correlated with the percentage of total sleep time below an oxyhemoglobin saturation of 90% （T90） （Beta = 0.215 and 0.368, P 〈0.05）; 30-min and 60-min glucose was negatively correlated with the lowest SpO2 （LSpO2） （Beta = -0.214 and -0.241, P 〈0.05）. HOMA-β and Dlowere negatively correlated with T90 （Beta = -0.153 and -0.169, P 〈0.05） while body mass index （BMI） was the only determinant of HOMA-IR and Matsuda index. Conclusions OSAS is associated with impairment in glucose tolerance and pancreatic β-cell function in Han Chinese subjects while insulin sensitivity is mainly determined by obesity.展开更多
目的：探讨2型糖尿病胰岛β细胞功能及胰岛素抵抗与微量白蛋白尿的相关关系。方法入选2型糖尿病患者524例，测量身高、体质量、腰围及血压。采集静脉血测量空腹血糖（FPG）、血脂、糖化血红蛋白（HbA1c）、空腹 C 肽（FPC），留取24 h ...目的：探讨2型糖尿病胰岛β细胞功能及胰岛素抵抗与微量白蛋白尿的相关关系。方法入选2型糖尿病患者524例，测量身高、体质量、腰围及血压。采集静脉血测量空腹血糖（FPG）、血脂、糖化血红蛋白（HbA1c）、空腹 C 肽（FPC），留取24 h 尿测量尿白蛋白排泄率（UAER），胰岛β细胞功能（HOMA-B）及胰岛素抵抗（HOMA-IR）采用 C 肽稳态模型评估，根据 HOMA-B 及 HOMA-IR 四分位数，分别将受试者分为四个亚组，即 q1～q4及 Q1～Q4。采用非参数趋势性检验对 HOMA-B 及 HOMA-IR 四分位分组人群各临床指标进行趋势分析，采用多因素 Logistic 回归分析评价2型糖尿病患者胰岛β细胞功能及胰岛素抵抗与微量白蛋白尿的关系。结果趋势性检验显示，随 HOMA-B 升高，UAER 逐渐减少，q1、q2、q3、q4组分别为8．92（5．53～28．65）、8．55（5．52～20．95）、7．57（4．79～19．83）、7．84（5．23～14．38）μg／min，趋势有统计学意义（z ＝－2．1， P ＜0．05），随 HOMA-IR 升高，UAER 逐渐增加，Q1、Q2、Q3、Q4组分别为6．73（4．85～16．52）、8．61（5．2～20.37）、8．31（4．88～27．04）、8．75（6．03～25．21）μg／min，趋势有统计学意义（z ＝2．41，P ＜0．05）。多因素Logistic 回归分析，HOMA-B 最高四分位比最低四分位人群微量白蛋白尿发病风险降低（校正 OR q4 vs q1＝0.39，95％CI：0．20-0．76，Wald ＝7．59，P ＝0．006），相反，HOMA-IR 最高四分位比最低四分位人群有较高微量白蛋白尿发病风险（校正 OR Q4 vs Q1＝2．00，95％CI：1．08-3．72，Wald ＝4．84，P ＝0．028）。结论胰岛素抵抗与2型糖尿病患者微量白蛋白尿发生增加有关，而较好胰岛β细胞功能与微量白蛋白尿发生降低有关。展开更多
文摘目的观察葛根素联合门冬胰岛素对妊娠期糖尿病(GDM)患者血清氧化相关物质、胰岛素抵抗及胰岛β细胞功能的影响。方法 GDM患者100例随机分为对照组和观察组,每组50例。对照组给予门冬胰岛素治疗,观察组在对照组基础上加用葛根素注射液治疗。比较2组空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(Hb A1c)、夜间血糖、谷胱甘肽过氧化物酶(GSH-PX)、超氧化物歧化酶(SOD)、活性氧(ROS)、丙二醛(MDA)活性、空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)、胰岛素分泌指数(ΔI_(30)/ΔG_(30))、混合胰岛素敏感度(ISIcomp)变化。结果 2组治疗后FBG、2 h PBG、Hb A1c、ROS、MDA、FINS、HOMA-IR较治疗前显著降低,GSH-PX、SOD、HOMA-β、ISI、ΔI_(30)/ΔG_(30)、ISIcomp较治疗前显著升高(P<0.05),但观察组以上指标改善程度优于对照组,差异有统计学意义(P<0.05)。结论葛根素联合门冬胰岛素能够有效降低妊娠期糖尿病患者血糖水平,纠正患者血清氧化和抗氧化物质失衡、改善胰岛素抵抗、保护胰岛β细胞功能。
文摘Background Increasingly, evidence from population, clinic-based and laboratory studies supports an independent association between obstructive sleep apnea syndrome （OSAS） and an increased risk of type 2 diabetes; however, this observation has yet to be replicated in China and the potential mechanisms that link these two conditions are not clear. Methods A total of 179 Han Chinese subjects were enrolled in this study. All subjects underwent polysomnography, the oral glucose tolerance-insulin releasing test （OGTT-IRT） and serum HbAlc measurement. Indexes including homeostasis model assessment-IR （HOMA-IR）, Matsuda index, HOMA-β, early phase insulinogenic index （△I30 / △G30）, AUC-I180 and oral disposition index （DIo） were calculated for the assessment of insulin resistance and pancreatic β-cell function. Results Based on OGTT, 25.4%, 44.6% and 54.5% subjects were diagnosed having glucose metabolic disorders respectively in control, mild to moderate and severe OSAS groups （P 〈0.05）. Serum HbA1c levels were highest in subjects with severe OSAS （P 〈0.05）. In contrast, compared with normal subjects, HOMA-β, △I30/△G30 and DIo were lower in severe OSAS group （P 〈0.05）. In stepwise multiple linear regressions, 0-min glucose and HbAlc were positively correlated with the percentage of total sleep time below an oxyhemoglobin saturation of 90% （T90） （Beta = 0.215 and 0.368, P 〈0.05）; 30-min and 60-min glucose was negatively correlated with the lowest SpO2 （LSpO2） （Beta = -0.214 and -0.241, P 〈0.05）. HOMA-β and Dlowere negatively correlated with T90 （Beta = -0.153 and -0.169, P 〈0.05） while body mass index （BMI） was the only determinant of HOMA-IR and Matsuda index. Conclusions OSAS is associated with impairment in glucose tolerance and pancreatic β-cell function in Han Chinese subjects while insulin sensitivity is mainly determined by obesity.
