摘要
目的探讨使用外源性胰岛素的2型糖尿病（T2DM）患者口服葡萄糖耐量试验（OGTr）各时间点血糖与胰岛8细胞分泌功能、胰岛素抵抗（IR）的相关性。方法对279例皮下注射胰岛素治疗的T2DM患者血糖达标后行OGTT试验。依据糖化血红蛋白（HbAlc）水平分为≥9％和〈9％两组，将空腹血糖（FPG）、空腹C肽（FCP）代入稳态模型2（HOMA2）计算胰岛β细胞分泌功能（HOMA2-β）、胰岛素抵抗（HOMA2-IR），并进行比较分析。结果多因素线性回归分析结果显示，各时间点血糖与HOMA2．B均呈负相关（P〈0．01）。HbA1c≥9％组FPG与HOMA2-IR呈正相关（t=3．620，P=0．001），而其他各时间点血糖与HOMA2-IR均不相关（P〉0．05）。HbAlc〈9％组FPG、0．5hPG与HOMA2-IR呈正相关（t=2．861，P=0．006，t=2．215，P=0．031），1hPG、2hPG、3hPG与HOMA2-IR均不相关（P〉0．05）。结论应用外源性胰岛素的T2DM患者OGTT中FPG可评价胰岛β细胞分泌功能及IR情况。血糖控制越差者餐后血糖对IR的判定意义越小。
Objective To investigate the relationship of islet β cell secretion function and insulin resistance （IR） with plasma glucose（PG） in oral glucose tolerance test （OGTT） in patients with type 2 diabetes mellitus（T2DM） by the exogenous insulin. Methods A total of 279 patients of T2DM with insulin therapy, when the PG completed goals, OGTF was orderd ,the patients were divided into HbAlc ≥9.0% group and HbAlc 〈9.0% group. The fasting plasma glucose（FPG）,fasting C-peptide（FCP） were used to calculate the islet [3 cell secretion function（（HOMA2-β） and IR（HOMA2-IR） by the homeostasis model assessment 2 （HOMA2）. Results Multiple linear regression analysis showed that there was negative correlation between PG and HOMA2 （ P 〈 0.01 ） at different time-point, including Oh, 0.5h, 1 h, 2h, 3h after the OGTT. There was positive correlation between FPG and HOMA2 （ t = 3. 620, P = 0. 001 ）, but PG at other time-points had no correlation in the HbAlc I〉9.0% group. In the HbAlc 〈 9.0% group, there was positive correlation between FPG,0.5h PG and HOMA2-IR （t = 2. 861 ,P = 0. 006,t = 2. 215, P=0. 031 ）, but there was no significant correlation between 1h PG,2h PG,2h PG and HOMA2-1R. Conclusion FPG in OGTT can be used to evaluate the function of islet β cell and IR in the patients of T2DM with insulin therapy. PG has less significance in the diagnosis of IR in patients with higher PG.
出处
《临床内科杂志》
CAS
2018年第2期101-103,共3页
Journal of Clinical Internal Medicine
关键词
口服葡萄糖耐量试验
胰岛Β细胞分泌功能
胰岛素抵抗
稳态模型2
Oral glucose tolerance test
Islet β cell secretion function
Insulin resistance
Homeostasis model assessment 2
