108例2型糖尿病患者病程中胰岛功能的变化

The effects of disease duration and other related facts on islet-beta cell function in 108 cases of type 2 diabetes

目的 分析病程及其他相关因素对2型糖尿病患者胰岛功能的影响.方法 收集主院患者中具有不同诊断病程且先后两次住院的2型糖尿病患者108例,将其按照诊断病程进行分组,比较各组患者在病程中与初诊时的胰岛功能,包括胰岛素分泌指数（HOMA-β）、胰岛素曲线下面积（AUCINR）和胰岛素峰值与空腹值比值（M/Fi）,分析同一个体不同时段胰岛功能的变化及其他相关因素对胰岛β细胞功能的影响.结果 随着病程延长,HOMA-β、AUCINR和胰岛素M/Fi值均呈逐渐下降的趋势,当病程达10年以上时,其HOMA-β与初诊时比较下降达48.79％,AUClNR与初诊时相比下降接近39.45％,M/Fi也从初诊时的4.44下降至2.71；通过相关分析结果显示,BMI与Fi及AUCINR呈正相关,TG与HOMA-β呈正相关.结论2型糖尿病患者胰岛功能随病程延长逐步衰退,且体重指数与TG对胰岛功能有一定影响,有效的降糖治疗在控制血糖的同时,可适当增加胰岛素的释放能力,但却无法改善因病程的延长而导致的胰岛功能降低.

Objective To evaluate the effects of disease duration and other relevant factors on is- let-beta cell function in type 2 diabetes. Methods Type 2 diabetic patients were divided into groups according to the disease duration, and compared with the time when they were newly diagnosed. There were three index（ HOMA-β,AUCINR, M/Fi） to evaluate the islet-beta cell function. Results The islet-beta cell function decreased gradually as the disease duration extended. HOMA-[3 was significantly lower than the time newly onset when disease duration exceeded 10 years, which decreased nearly 48.79%. AUCINR decreased nearly 39.45% ,and M/Fi dropped from 4.44 to 2.71. Through Pearson correlation analysis, BMI was positively related to Fi and AUCINR,TG and HOMA-β was positively correlated aslo. Conclusion Islet-beta cell function decreases with type 2 diabetes duration. BMI and TG have a certain influence on islet function. Effective hypoglycemic therapy in blood sugar control may be appropriate to increase the release of insulin,but can not improve islet function for the duration of the extension and reduction.