不同空腹血糖状态人群的C肽值意义

Clinical significance of C-peptide in subjects with different blood glucose levels under fasting state

目的探讨C肽值在不同空腹血糖水平人群中的意义。方法选择上海市杨浦区部分社区居民2051名,参照2003年美国糖尿病协会(ADA)关于空腹血糖受损(IFG)的诊断切割点,按不同空腹血糖水平(FPG)分为5组。结果与FPG<5.6mmol/L的两组相比,FPG≥5.6mmol/L各组的空腹C肽(FC)值均明显增高(P<0.05),但5组间餐后2hC肽值的差异无显著性(P>0.05)。5组间空腹胰岛素和餐后2h胰岛素的差异均无显著性(P>0.05)。各组间HOMAβ细胞功能指数(HBCI)值的差异均有显著性(P<0.05)。单因素分析显示,FC与FPG、腰围、腰臀比(W/H)、体重指数(BMI)、收缩压(SBP)均成正相关(P<0.01),但与HBCI成负相关(P<0.01)。以FC值为自变量,上述指标为应变量进行多元回归分析,FPG、HBCI、腰围、BMI、SBP纳入回归方程。结论在不同FPG人群中,FC值在FPG≥5.6mmol/L以上阶段可能升高,且与血糖、胰岛β细胞功能指数有明显的相关性。

Objective To investigate the clinical significance of C-peptide in subjects with different fasting blood glucose levels. Methods In a community-based study, 2051 residents were tested with OGTT and divided into five groups according to WHO diagnostic criteria (1999) and the ADA Expert Committee recommended criteria (2003) on diabetes, i.e. Fasting blood glucose, insulin and C-peptide levels were tested. Results Compared to group FPG 5.0-5.5 mmol/L [(0.26±0.16) nmol/L], the C-peptide level was higher in group FPG 5.6-6.0 mmol/L [(0.31±0.27) nmol/L, P<0.01]. Among the groups of FPG above 5.6-6.0 mmol/L or those below 5.1-5.5 mmol/L, no statistical significance could be observed. As to the insulin level, there existed an increasing tendency but of no statistical significance. C-peptide level was correlated well with FPG,HBCI (P=0.005). HBCI was lowered in correlatatire analysis which was shown in group FPG above 5.6 mmol/L (P<0.01). Conclusions C-peptide levels differ in subjects with different fasting blood glucose levels, higher in group FPG above 5.6 mmol/L, and well correlate with FPG and HBCI.