[1]张曙晴a,李洪彬b,张骆军a,等.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,2016,31(02):108-111.[doi:10.3969/j.issn.1671-7414.2016.02.032]
　ZHANG Shu-qinga,LI Hong-binb,ZHANG Luo-juna,et al.Correlation between Insulin Secretion,Insulin Resistance and Glycosylated Hemoglobin Levels in Patients with Type 2 Diabetic[J].Journal of Modern Laboratory Medicine,2016,31(02):108-111.[doi:10.3969/j.issn.1671-7414.2016.02.032]
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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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《现代检验医学杂志》[ISSN:/CN:]

卷:
第31卷
期数:
2016年02期
页码:
108-111
栏目:
检验与临床
出版日期:
2016-06-01

文章信息/Info

Title:
Correlation between Insulin Secretion,Insulin Resistance and Glycosylated Hemoglobin Levels in Patients with Type 2 Diabetic
作者:
张曙晴a; 李洪彬b; 张骆军a; 王峥骅a
南通市第二人民医院a.检验科; b.内分泌科,江苏南通 226002
Author(s):
ZHANG Shu-qinga; LI Hong-binb; ZHANG Luo-juna; WANG Zheng-huaa
a.Department of Clinical Laboratory; b.Department of Endocrinology, the Second People's Hospital of Nantong,Jiangsu Nantong 226002,China
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
分类号:
R587.1; R446.112
DOI:
10.3969/j.issn.1671-7414.2016.02.032
文献标志码:
A
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%<HbA1c≤9%),C组(9%<HbA1c≤11%)和D组(HbA1c>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。
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%<HbA1c≤9%,group C with 9%<HbA1c≤11% and group D with HbA1c>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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备注/Memo

备注/Memo:
作者简介:张曙晴(1977-),女,学士学位,主管检验师,专业:生化检验,Tel:0513-85554340,E-mail:zhangshuqing9216@sina.com。
更新日期/Last Update: 2016-02-20