摘要
目的:分析2型糖尿病患者初始胰岛素剂量与代谢参数之间的关系,探索更合理估计初始胰岛素剂量的方法。方法:收集初次应用胰岛素治疗的2型糖尿病住院患者164例,询问病史,测量身高、体质量、腰围、臀围、血压,检测空腹血糖、胰岛素、C肽、糖化血红蛋白(HbA1c)、血脂,进行精氨酸试验。结果:2型糖尿病患者的初始胰岛素剂量与胰岛素抵抗指数(HOMA-IR)(r=0.416,P<0.001)、空腹胰岛素(r=0.372,P<0.001)、三酰甘油(TG)(r=0.212,P=0.007)、空腹血糖(r=0.180,P=0.021)、腰围(r=0.170,P=0.029)、精氨酸试验的血糖曲线下面积(r=0.167,P=0.032)呈正相关。在糖尿病病程≤1年的患者中,空腹胰岛素和C肽水平、HOMA-IR是影响初始胰岛素剂量的主要因素,回归方程分别为:初始胰岛素剂量=1.031×空腹胰岛素-2.975×空腹C肽+24.56,或初始胰岛素剂量=1.256×HOMA-IR+22.489。在糖尿病病程>1年的患者中,腰围、TG和空腹血糖水平是影响患者初始胰岛素剂量的主要因素,回归方程分别为:初始胰岛素剂量=0.381×空腹胰岛素-4.506×高密度脂蛋白胆固醇HDL-c+31.83,或初始胰岛素剂量=0.206×腰围+0.585×TG+0.668×空腹血糖+3.709。结论:空腹胰岛素、空腹C肽、HOMA-IR是新诊断2型糖尿病患者的初始胰岛素剂量的主要影响因素。空腹胰岛素、HDL-c、腰围、TG和空腹血糖是病程超过1年的2型糖尿病患者初始胰岛素剂量的影响因素。
Objective:To analyze the relationship between initial insulin dosage for type 2 diabetes(T2D) and the metabolic parameters and to explore a more reasonable method for evaluating the initial insulin dosage.Methods: We enrolled 164 inpatients with T2D who initially treated with insulin and collected their data including personal history,height,weight,waist and hip circumferences,blood pressure and the laboratory examinations including fasting blood glucose,insulin and C peptide,HbAlC,lipid profile.All the patients performed the arginine stimulating test to observe the acute phase secreting function of β cells.Results: The initial insulin dosage for patients with T2D was positively related to HOMA-IR(r=0.416,P0.001),fasting blood insulin(r=0.372,P0.001),triglyceride TG(r=0.212,P=0.007),fasting blood glucose(r=0.180,P=0.021),waist circumference(r=0.170,P=0.029),area under the blood glucose curve in arginine stimulating test(r=0.167,P=0.032).In the patients with a diabetes history no more than 1 year,fasting blood insulin and C peptide,HOMA-IR were the main impact factors and the regression equations were respectively as follows,initial insulin dosage=1.031×fasting blood insulin-2.975×fasting C peptide+24.56,and initial insulin dosage=1.256×HOMA-IR+22.489;on the other hand,among patients with a diabetes history more than 1 year,waist circumference,TG and fasting blood glucose were the main impact factors,the regression equations were respectively as follows,initial insulin dosage = 0.381×fasting blood insulin-4.506×HDL-c+31.83,and initial insulin dosage=0.206×waist circumference+0.585×TG+ 0.668×fasting blood glucose+3.709.Conclusions: Fasting blood insulin,fasting C peptide,HOMA-IR were the main impact factors of the initial insulin dosage for newly diagnosed type 2 diabetic patients.Fasting blood insulin,HDL-c,waist circumference,TG and fasting blood glucose are the impact factors of the initial insulin dosage for type 2 diabetic patients with a history more than 1 year.
出处
《中国临床医学》
2010年第4期530-532,共3页
Chinese Journal of Clinical Medicine
关键词
糖尿病
胰岛素剂量
代谢参数
Diabetes
Insulin dosage
Metabolic parameter