论文部分内容阅读
目的比较不同HbA1c水平的新诊断T2DM患者血糖、IS与胰岛素分泌功能、慢性并发症等情况。方法选取新诊断T2DM患者210例,根据HbA1c水平分为3组,用稳态模型胰岛素抵抗指数(HOMA-IR)、定量胰岛素敏感指数(QUICKI)、OGTT胰岛素敏感指数(OGIS)评估IS,HOMA-β、AUCIns及AUCR评估胰岛素分泌功能。对HbA1c的影响因素进行逐步多元回归分析。经多个独立样本非参数检验比较各组慢性并发症发生率。结果组间比较显示,随着HbA1c的升高,各时点血糖均明显升高,FIns及餐后2hIns水平明显下降。OGIS、HOMA-β、AUCIns及AUCR均显著下降(P<0.01)。HbA1c与2hPG呈显著正相关(r=0.675,P<0.01),与HOMA-β、OGIS呈显著负相关(r=-0.632,-0.578,P<0.01)。各组慢性并发症发生率均较高,但差异无统计学意义(P>0.05)。结论新诊断T2DM患者已处在高HbA1c水平,IS显著下降,胰岛分泌功能已明显受损,慢性并发症发生率高。
Objective To compare the blood glucose, IS, insulin secretion and chronic complications of newly diagnosed T2DM patients with different HbA1c levels. Methods Totally 210 newly diagnosed T2DM patients were selected and divided into 3 groups according to their HbA1c levels. The levels of IS, HOMA-1, IL-6, IL-6 and IL-6 were assessed by means of HOMA-IR, QUICKI and OGTT. β, AUCIns and AUCR to assess insulin secretion. The influencing factors of HbA1c were analyzed by stepwise multiple regression analysis. The incidence of chronic complications in each group was compared by multiple independent non-parametric tests. Results Comparisons between groups showed that with the increase of HbA1c, the levels of blood glucose were significantly increased at various time points, and the levels of FIns and 2hours after meal decreased significantly. OGIS, HOMA-β, AUCIns and AUCR decreased significantly (P <0.01). There was a significant positive correlation between HbA1c and 2hPG (r = 0.675, P <0.01), but negatively correlated with HOMA-β and OGIS (r = -0.632, -0.578, P <0.01). The incidence of chronic complications in each group were higher, but the difference was not statistically significant (P> 0.05). Conclusions Newly diagnosed T2DM patients are already at high HbA1c level, with a significant decrease in IS and markedly impaired islet secretion and a high incidence of chronic complications.