口服降糖药控制不佳的2型糖尿病患者HbA1c水平与胰岛β细胞功能的相关性

The correlation between glycated hemoglobin A1c and islet β cell function in poorly controlled type 2 diabetic patients treated with oral antidiabetic drugs

目的观察口服降糖药控制不佳的T2DM患者HbA1c与β细胞功能的关系。方法 T2DM患者464例,按HbA1c水平分为4组:A组,HbA1c≤7.0%;B组,7.0%<HbA1c≤9.0%;C组,9.0%<HbA1c≤11.0%;D组,HbA1c>11.0%。比较各组间HOMA-IR、HOMA-β、早时相胰岛素分泌指数(△I30/△G30)、晚时相胰岛素分泌等的变化。结果随HbA1c升高,HOMA-β、△I30/△G30、胰岛素曲线下面积(AUCI)均逐渐降低(P<0.01),以△I30/△G30最明显(各组△I30/△G30自然对数值依次为1.00±0.15、0.50±0.07、0.40±0.05、0.10±0.03);随HbA1c升高,HOMA-IR呈升高趋势,B、C、D组(分别为1.1±0.4、1.2±0.3、1.2±0.4)明显高于A组(0.8±0.3)(P<0.01)。结论口服降糖药控制不佳的T2DM患者,随HbA1c的升高,在胰岛素抵抗增加的同时,β细胞分泌功能也受到抑制,尤以早时相胰岛素分泌为著。

Objective To investigate the correlation between islet β cell function and glycated hemoglobin A1c（HbA1c） in poorly controlled type 2 diabetic patients treated with oral antidiabetic drugs.Methods 464 cases of type 2 diabetic patients were divided into four groups： HbA1c≤7.0%（Group A）,7.0%HbA1c≤9.0%（Group B）,9.0%HbA1c≤11.0%（Group C） and HbA1c11.0%（Group D）. Results The gradually increased levels of HOMA-IR and AUCg were found and gradually decreased levels of HOMA-β,ISI,△I30/G30,and DI occurred along with the increase of HbA1c. Conclusions In poorly controlled type 2 diabetic patients treated with oral antidiabetic drugs,insulin resistance is elevated while islet β cell function,especially the early phase insulin secretion,is decreased,along with the increase of HbA1c.