| 2型糖尿病患者糖化血红蛋白水平与胰岛素分泌及胰岛素抵抗的关系 |
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| 引用本文： | 张曙晴a,李洪彬b,张骆军a,王峥骅a.2型糖尿病患者糖化血红蛋白水平与胰岛素分泌及胰岛素抵抗的关系[J].现代检验医学杂志,2016,0(2):108-111. |
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| 作者姓名： | 张曙晴a 李洪彬b 张骆军a 王峥骅a |
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| 作者单位： | 南通市第二人民医院a.检验科; b.内分泌科,江苏南通 226002 |
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| 摘 要： | 目的 比较不同糖化血红蛋白(HbA1c)水平的2型糖尿病(T2DM)患者胰岛素分泌和胰岛素抵抗情况,了解葡萄糖毒性对胰岛β细胞分泌功能的影响。方法 将137例T2DM患者,按HbA1c水平分为4组,即A组(HbA1c≤7%),B组(7%11%),测定各组空腹血糖(FPG),HbA1c及精氨酸刺激前后各时点的胰岛素(INS)。用稳态模型评估法评价基础胰岛素分泌功能(HOMA-β)和胰岛素抵抗指数(HOMA-IR),并用精氨酸刺激后血糖校正胰岛素增值(△INS/FPG)评估第一相胰岛素分泌功能。结果 各组T2DM患者FPG差异均有统计学意义(F=15.633～106.154,P值均<0.01),且与HbA1c呈正相关(r=0.627,P<0.01); HOMA-β和△INS/FPG均表现为A组、B组分别与其他各组差异有统计学意义(F=4.106～16.255,P值均<0.05),但C组与D组之间差异无统计学意义(F=0.761,2.756,P值均>0.05); A组HOMA-IR与C组、D组之间差异有统计学意义(F=4.836,8.524,P值均<0.05); 精氨酸刺激后胰岛素分泌不足检出率在HbA1c>9%时明显升高。结论 胰岛β细胞功能的判断受长期糖毒性的干扰,故将T2DM患者的HbA1c控制在9%以下进行胰岛素分泌功能评估及精氨酸刺激试验,能较为准确地反映胰岛β细胞功能。
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| 关 键 词： | 2型糖尿病 葡萄糖毒性 胰岛素分泌 胰岛素抵抗 糖化血红蛋白 |
Correlation between Insulin Secretion,Insulin Resistance
and Glycosylated Hemoglobin Levels in Patients with Type 2 Diabetic |
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| ZHANG Shu-qinga,LI Hong-binb,ZHANG Luo-juna,WANG Zheng-huaa.Correlation between Insulin Secretion,Insulin Resistance
and Glycosylated Hemoglobin Levels in Patients with Type 2 Diabetic[J].Journal of Modern Laboratory Medicine,2016,0(2):108-111. |
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| Authors: | ZHANG Shu-qinga LI Hong-binb ZHANG Luo-juna WANG Zheng-huaa |
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| Affiliation: | a.Department of Clinical Laboratory; b.Department of Endocrinology,
the Second People's Hospital of Nantong,Jiangsu Nantong 226002,China |
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| Abstract: | Objective To compare insulin secretion and Insulin resistance of type 2 diabetic patients with different HbA1c levels,and toevaluate the effect of glucose toxicity on the islet β cell response.Methods 137 cases type 2 diabetes mellitus(T2DM)patients were divided into 4 groups according to HbA1c levels:group A with HbA1c≤7%,group Bwith 7%11%.Detected fasting blood glucose(FPG),HbA1c and each time point of insulin(INS)after arginine stimulation.Homeostasis model assessment was used to evaluatebasal insulin secretion(HOMA-β)and insulin resistance(HOMA-IR).The incremental value of insulin by blood glucose corrected(△INS/FPG)after arginine stimulation was used to evaluate the first phase insulin secretion.Results The level of FPG had significant differencein each group of T2DM patients(F=15.633～106.154,P<0.01),and was positively correlated with HbA1c(r=0.627,P<0.01).The level of HOMA-β and △INS/FPG were showed that group A and B were statistical significant difference with the other groups(F=4.106～16.255,P<0.05),but the difference was not statistical significant between group C and group D(F=0.761,2.756,P>0.05).The level of HOMA-IR in group A was statistical significant comparing group C and groupD(F=4.836,8.524,P<0.05).After arginine stimulation,the detection rate of the decreased function of insulin secretion increased significantly withHbA1c >9%.Conclusion The measurement of islet β cell's function was influenced by long-term high glucose toxicity.Therefore,patients with T2DM,which the level of HbA1c was less than 9%,were conducted with insulin secretion function evaluation and arginine stimulation test,this could reflect the function of islet βcell more accurately. |
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