初诊2型糖尿病患者胰岛分泌功能及胰岛素敏感性的评估

Evaluation of β-cell function and insulin sensitivity in newly-diagnosed patients with type 2 diabetes mellitus

目的探索初诊2型糖尿病患者的胰岛分泌功能及胰岛素敏感性。方法185例初诊2型糖尿病患者按糖化血红蛋白水平分成4组。组1患者糖化血红蛋白水平≤8.875%、组2为8.875%～12.55%、组3为12.55%～16.225%、组4≥16.225%。比较各组初诊时的临床及生化指标特点、胰岛素分泌功能指数HOMA2-%B和胰岛素敏感指数HOMA2-%S。结果糖化血红蛋白水平较高者,其出现糖尿病典型症状的比率显著上升,酮症发病率亦上升。空腹及餐后2hC肽水平明显下降。各组HOMA2-%B呈明显下降趋势,且组间HOMA2-%S无显著差异。结论初诊2型糖尿病患者的胰岛分泌功能受损程度较其胰岛素敏感性下降更为严重,且初诊时糖化血红蛋白水平较高者,其胰岛素分泌功能下降更为显著。

Objective To investigate D-cell function and insulin sensitivity in newly-diagnosed type 2 diabetic patients. Methods Totally 185 newly diagnosed type 2 diabetic patients were divided into 4 groups according to HbAlc level： lower than 8.875%, 8.875% to 12.55%, 12.55% to 16.225%, higher than 16.225%. Clinical characteristics, biochemical parameters, HOMA2-%B and HOMA2-%S were analyzed. Results The occurrence rate of diabetic symptoms increased as HbA1c level increased, and the incidence of ketosis also increased. Fasting and postprandial 2h C-peptide levels decreased significantly. HOMA2-%B decreased in all groups, and there was no significant difference in HOMA2-%S among groups. Conclusion β-cell function decreased more severely than insulin sensitivity in newly-diagnosed type 2 diabetic patients. HOMA2-%B decreased significantly as HbAlc level increased.