2型糖尿病患者血清微量元素水平及糖代谢指标的相关性

摘要

目的：探讨2型糖尿病（T2DM）患者血清微量元素含量的变化，及其与部分生化指标、T2DM发生发展的相关性。方法检测2012年6月至2014年6月入住上海市徐汇区中心医院内分泌科的89例T2DM（T2DM组）患者和97例非T2DM（对照组，一般资料与T2DM组比较无差异）患者的空腹血糖（FBG）、餐后2h血糖（2hPBG）、糖化血红蛋白（HbAlc）、空腹胰岛素（FINS）、C肽等生化指标。采用电感耦合等离子体质谱（ICP-MS）技术检测铁（Fe）、锌（Zn）、硒（Se）3种微量元素含量，分析微量元素与生化指标及T2DM的关系。结果与对照组比较，T2DM组血清Zn、Se含量均显著降低（P＜0.05）；与HbAlc＜7.0%者比较，T2DM组中HbAlc≥7.0%者血清Fe、Zn、Se含量显著降低（P＜0.05）；Pearson相关性分析显示，T2DM患者血清Fe与Zn之间和Fe与Se之间分别呈正相关，Zn与Se之间亦呈正相关（r＝0.668、0.725、0.754；P＜0.05）；Fe、Zn、Se与HbAlc、FBG、2hPG、FINS及C肽均具有良好的相关性；多因素logistic回归分析显示， Zn、Se是T2DM患者的保护因素（β＝−1.302，−1.578；P＜0.05）。结论 T2DM患者微量元素含量普遍较低，且与糖代谢密切相关，维持体内微量元素的平衡，对防止或延缓T2DM发病具有积极的意义。%ObjectiveTo explorethe changesinserum trace elementsandits correlation with biochemical indicators and development of type 2 diabetesmellitus(T2DM) in patients with T2DM.MethodsA total of89 patients withconfirmedT2DMadmitted inthe Endocrinology Department, Xuhui DistrictCentral Hospital of Shanghai from June 2012 to June 2014 were enrolled in this study. Another 97 non-T2DMpatients(having no significant differences in age, sex, body mass index, and waist-hip ratio with the T2DM group) in our hospital at the same duration were recruited as control group.Fasting blood glucose(FBG),2-hour postprandial glucose (2hPBG), glycosylatedhemoglobin A1c(HbAlc),fasting insulin(FINS),andpeptide C weremeasured. Inductively coupled plasma mass spectrometry (ICP-MS) was used to detect theserumlevels of trace elements, Fe, Zn and Se. The correlation of serum trace elements with biochemical indicators and T2DM wasanalyzed.ResultsSerumlevels of Fe, Zn and Se were significantlylower in T2DM groupthanincontrolgroup (P<0.05), and also remarkably reduced in the T2DM patients with HbAlc≥7.0%thaninthose with HbAlc<7.0% (P<0.05). Pearson correlation analysis showed that therewas positive correlation between Fe and Zn, Fe and Se, and Zn and Se,respectively (r=0.668, 0. 725, 0.754,P<0.05). Serum levels of Fe, Zn and Se were all highly correlated with HbAlc, FBG, 2hPBG,FINS and peptide C. Multivariate logistic regression analysis showed that Zn and Se were the protective factorsfor T2DM (β=-1.302,-1.578;P<0.05).Conclusion The serum levels of trace elements are generally low in T2DM patients, andthe levels are closely related to the glycometabolism. So maintaining the balance of trace elementsis ofpositive significancein the prevention or onset delay ofT2DM.