新诊断的肥胖和非肥胖2型糖尿病患者的临床比较研究

The Clinical Comparison Between the Obese and Non-obese Patients with Newly Diagnosed Type 2 Diabetes Mellitus

【目的】提高对2型糖尿病(T2DM)肥胖患者代谢紊乱的认识。【方法】81例新诊断的T2DM患者根据体质指数(BMI)分为肥胖和非肥胖两组,肥胖组40例,非肥胖组41例。检测两组的腰围、臀围、血压、空腹血糖(FPG)、餐后2h血糖(2hPG)、空腹C肽(FCP)、餐后2hC肽(2hCP)、血清谷丙转氨酶(GPT)、肾功能、糖化血红蛋白(HbA1C)、血脂全套以及心电图和腹部B超,并进行比较分析。【结果】肥胖组的BMI、腰/臀比、血尿酸、FCP和2hPCP明显高于非肥胖组(P<0.01),肥胖组收缩压、舒张压和血清谷丙转氨酶较非肥胖组略高(P>0.05),肥胖组中合并中心性肥胖、高血压、高脂血症和非酒精性脂肪肝者比例显著高于非肥胖组(P<0.01)。【结论】新诊断的T2DM患者中,肥胖患者较非肥胖患者有更严重的代谢紊乱,对肥胖的T2DM患者应采取综合治疗,不仅要控制血糖,还要减肥和减轻胰岛素抵抗。

[ObjectivelTo comprehend the metabolic disorder of the obese patients with type 2 diabetes mellitus（T2DM）. [Methods]According to body mass index（BMI）, 81 cases of newly diagnosed T2DM were divided into 2 groups;obesity （40 cases） and non-obesity （41 cases）. The waist circumference（W）, hip circumference（H）, fasting plasma glucose（FPG）, 2-hour postprandial plasma glucose（2hPG）, fasting C peptide （FCP）, 2-hour postprandial C peptide（2hCP）, serum glutamic-pyruvic transaminase（GPT）, renal function, glyeosylated hemoglobin（HhAlC） and blood lipid were tested ,electrocardiogram and abdominal uhrasonometry were performed, then all data were comparatively analysed. [Rcsults]The BMI, the ratio of W/H（WHR）, serum uric acid（BUA）, FCP and 2hCP in the obese group were higher than those in non-obese group（ P 〈0. 01 ）, systolic blood pressure, diastolic blood pressure and GPT in obese patients were higher than those in the non-obese group（ P 〉0.05）, while the prevalence of abdorminal obesity, hypertension, blood lipid disorder and nonalcoholic fatty liver disease（NAFLD） significantly increased in obese group than those in non-obese group. [Conclusion]Among the newly diagnosed T2DMs, metabolic disorder in obese patients is even more serious. It is very important for obese patients with T2DM to give combined treatment to improve the metabolic disorder, that includes controlling blood glucose ,decreasing weight and lightening insulin resistance.