不同病期T1DM患儿ISF及其与C-P/FBG的相关性研究

Study on the different insulin sensitivity factor and correlation between ISF and C-P/FBG in different period of children with type 1 diabetes mellitus.

【目的】研究儿童Ⅰ型糖尿病(type 1 diabetes mellitus,T1DM)强化治疗不同病期胰岛素敏感指数(insu-lin sensitivity factor,ISF)及其与C-肽/空腹血糖(C-peptide/fasting blood glucose,C-P/FBG)的直线相关关系。【方法】连续观察12例T1DM患儿急性代谢紊乱期(急性期)、暂时缓解期(蜜月期)及强化期空腹血糖(FBG)、空腹C-P、C-P/FBG,计算三期的ISF,比较之间的差异;观察ISF与C-P/FBG之间的直线相关关系。【结果】T1DM患儿不同病期ISF不同,急性期与蜜月期、蜜月期与强化期差异均有显著性,而急性期与强化期差异无显著性。ISF与C-P之间呈显著性直线正相关(r=0.92,P<0.001)。回归方程:Y=2.42+25.63X(Y=ISF,X=C-P/FBG)。【结论】儿童T1DM患儿不同病期ISF不同,蜜月期ISF显著高于急性期及强化期,根据ISF对计划用胰岛素进行微调,可使血糖波动小,达到强化治疗目的,进而减少慢性并发症的发生。

[Objective] To study the different insulin sensitivity factor （ISF） and correlation between ISF and Cpeptide/fasting blood glucose（C-P/FBG） in different periods of children with type 1 diabetes mellitus（T1DM）. [Methods] FBG,C-P,C P/FBG were continuous observed in twelve newly diagnosed patients with T1DM during acute metabolic disturbance period（acute period）, temporary remission period（honeymoon period） and reinforcement period;calculated ISF of three periods,compared the differences of ISF among three periods. Linear correlation analysis was made between ISF and C-P/FBG. [Results] ISF was significantly higher in honeymoon period than in acute or reinforcement period, there was no significantly difference between acute and reinforcement period. There was a significant positive linear correlation between ISF and C-P/FBG （r=0.92,P〈0. 001）;the regression equation：Y=2.42＋ 25.63X[Y= ISF,X-C-P/FBG]. [Conclusion] ISF is significantly higher in honeymoon period than in acute and reinforcement period. According to ISF, regulated slightly the planed insulin dosage and therefore result in small change of blood glucose and easily attain the aim of intensive therapy in order to decrease chronic complication.