HbAlc水平与新发2型糖尿病患者糖代谢紊乱程度及胰岛功能的相关性研究

摘要

目的 探讨糖化血红蛋白(HbAlc)水平与新发2型糖尿病(T2DM)患者糖代谢紊乱程度和胰岛功能的相关性.方法 2015年1月至2016年9月T2DM患者220例,根据患者HbAlc水平分为低糖化组(112例)和高糖化组(108例).所有患者均行葡萄糖耐量试验(OGTT)及胰岛素肽释放实验(Ins),采用HOMA-β、HOMA-IR、WBISI、ΔI30/ΔG30、AUCI60～120/G60～120等相关指数评估胰岛功能,通过Spearman相关分析及多元线性回归方法,分析HbAlc水平分与胰岛功能的相关性.结果 (1)随着HbAlc的升高,G-30、G30、G60、G120、G180、HOMA-IR、ΔI30/ΔG30逐渐升高(P<0.05),而I-30、I60、I120、I180、HOMA-β、AUCI60～120/G60～120则随着HbAlc的升高而逐渐降低(P<0.05).(2)Pearson相关分析显示HbAlc与WBISI呈正相关,与HOMA-β、HOMA-IR、WBISI、ΔI30/ΔG30、AUCI60～120/G60～120呈负相关(P<0.05).(3)多元线性回归显示HbAlc与HOMA-β、HOMA-IR、ΔI30/ΔG30、AUCI60～120/G60～120呈显著线性相关性(P<0.05),标准化回归系数Beta分别为1.003、0.224、0.674、-2.378.结论 新发T2DM患者HbAlc随血糖紊乱程度的升高而升高,随着HbAlc的升高胰岛功能损伤逐渐加重.%Objective To investigate the relationship between HbAlc,disorder of glucose metabolism and islet function in T2DM patients.Methods Clinical data of 220 patients with T2MD in our hospital from January 2015 to September 2016 were retrospectively analyzed and divided into low HbAlc group(112 cases)and high HbAlc group(108 cases)according to HbAlc level. All patients were enrolled in the OGTT and insulin releasing test(INS). The HOMA-β、HOMA-IR、WBISI、ΔI30/ΔG30 and AUCI60～120/G60～120 were used as parameters to evaluate the degree of islet function.Pearson correlation analysis and multivariate linear regression analysis were used to analysis the correlation between HbAlc level points and islet function. Results (1)With the increase of HbAlc,the levels of G-30,G30,G60,G120,G180,HOMA-IR、ΔI30/ΔG30 increased(P<0.05),yet I-30,I 60,I120,I180,HOMA-β,AUCI60～120/G60～120 decreased(P<0.05).(2)Pearson correlation analysis showed that HbAlc was positively correlated with WBISI,but negatively correlated with HOMA-β,HOMA-IR,WBISI,ΔI30/ΔG30,AUCI60～120/G60～120(P<0.05). Multi-variate linear regression analysis showed that HOMA-β,HOMA-IR,ΔI30/ΔG30,AUCI60～120/G60～120 had a significant linear correlation with HbAlc(P<0.05),the standardized regression coefficients were 1.003,0.224,0.674,-2.378. Conclusion HbAlc has positive correlation with disorder of glucose metabolism,and the islet function damage increases with the increase of HbAlc.