初诊2型糖尿病患者胰岛β细胞功能观察

The observation of beta-cell function in newly diagnosed type 2 diabetic patients

目的观察初诊2型糖尿病患者胰岛β细胞功能。方法250例患者进行口服葡萄糖耐量试验(OGTT)及胰岛素释放试验(IRT)。按HOMA模型计算HOMAIS,HOMAIR用逐步多元线性回归模型分析影响胰岛素分泌功能的因素。结果(1)随FPG升高,胰岛β细胞功能逐步下降;FPG≥8.2mmol/L,下降明显(P<0.05);FPG≥11.1mmol/L,出现空腹胰岛素水平下降;FPG≥13.9mmol/L,细胞功能进一步衰退(P<0.01)。(2)逐步回归分析显示:胰岛β细胞功能与FPG呈显著负相关,与胰岛素水平和胰岛素抵抗呈显著正相关(P均<0.01)。结论随着初诊2型糖尿病患者FPG升高,胰岛素分泌功能呈不同水平下降;高血糖的毒性作用最终导致胰岛素分泌功能衰竭。因此,必须尽早给予严格的血糖控制,保护β细胞功能,延缓β细胞衰竭。

Objective To study the pancreaticl3-cell function in newly diagnosed type 2 diabitic patients. Methods 250 participants received 75g oral glucose tolerance test and insulin release test. Insulin resistance（IR） and β-cell function were assessed by HOMA-IR index and HOMA-IS index respectively. Results （ 1 ） The residual pancreaticβ-cell function had a decreasing trend with the increase of the onset FPG;IS decreased significantly after FPG≥8.2 mmol/L; FINS firstly decreased after FPG ≥ 11. 1mmol/L;IS declined more. （2）Stepwise regression analysis showed that IS was negatively correlated with the onset FPG but positively with plasma insulin level and IR. Conclusions The residual pancreaticβ-ceU function has a decreasing trend with the increase of the onset FPG in the newly diagnosed type 2 diabitic patients;The toxicity effection of hyperglucose will lead to breakdown of the pancreaticβ-cell function. Therefore, the strict control of blood glucose must be adopted early, so as to protect the residual pancreaticβ-cell function and postpone breakdown of β-cell.