不同糖耐量人群血浆糖化血红蛋白与胰岛β细胞第一时相分泌的变化

The relation between glycosylated hemoglobin and the first-phase insulin secretion ofβcells in normal and impaired glucose tolerance and T2DM subjects

目的通过观察不同糖耐量人群HbA1c、胰岛β细胞第一时相分泌，初步探讨指标间的相互关系。方法纳入新诊断T2DM患者（T2DM组）115例、糖调节受损患者（IGR组）110例及正常对照者（NGT组）122例，以葡萄糖刺激后3～5min急性胰岛素反应（AIR3-5）表示第一时相胰岛素分泌功能指数，测定HbA1c、血脂并进行组间比较。结果T2DM组HbA1c（9．62±2．71）％高于IGR组（6．81±1．51）％及NGT组（4．11±0．64）％，而AIRK（7．62±3．21）低于IGR组（25．49±6．54）及NGT组（56．41±8．32）（P〈0．05）；IGR组HbA1C高于NGT组，而AI民5低于NGT组（P〈0．05）；AIRM与HDLC呈正相关，与HbA1c、TG、LDL-C、BMI呈负相关。结论从NGT、IGR到T2DM的发生发展过程中，AIR3-5水平逐渐降低，相应出现HbA1c升高。

Objective To investigate the relation between HbA1 c and the first-phase insulin secretion of β cells of pancreas in individuals with different levels of glucose tolerance. Methods 125 patients with newly diagnosed T2DM （T2DM group）, 110 patients with impaired glucose regulation （IGR group）, and 122 individuals with normal glucose tolerance （NGT group）were enrolled in the study. AIR3-5 reflected the first-phase insulin secretion function after the glucose loading. HbA1c, TC,TG, LDLC, and HDL-C were determined for comparison. Results The level of HbA1c （9. 62±2. 71）% was higher in the T2DM group than in the IGR group（6. 81±1.51）% and NGT group（4. 11±0. 64）± （P〈0. 05）, while the level of AIR3-5 （7.62±3.21） was lower in the T2DM group than that in the IGR group（25.49± 6.54） and NGT group （ 56.41 ± 8. 32） （P〈0. 05 ）, and the differences were statistically significant. The level of HbA1 c was higher and the level of AIR3-5 was lower in the IGR group than those in the NGT group （P〈0.05）. AIR3s was positively correlated with HDL-C, and negatively correlated with HbA1c, TG, LDL-C, and BMI. Conclusion During the course of disease from NGT to IGR to T2DM, AIR3-5 is gradually decreasing followed by plasma HbA1 c increasing. The level of HbA1 c may be used as one of simple clinical indexes to evaluate the function of insulin secretion of β cells.