2型糖尿病患者血清γ-谷氨酰转移酶与胰岛β细胞功能的关系

Association of serum gamma-glutamyltransferase with islet β cell function in type 2 diabetic patients

目的:观察血清γ-谷氨酰转移酶(GGT)水平与2型糖尿病患者胰岛β细胞功能之间的关系。方法:选取2型糖尿病患者240例,根据GGT水平四分位数分组,由低到高分为Q1组(GGT≤16.4 IU/L)62例、Q2组(16.4 IU/L<GGT≤26.4 IU/L)59例、Q3组(26.4 IU/L<GGT≤42.9 IU/L)61例、Q4组(GGT>42.9 IU/L)58例。收集所有患者一般临床资料,评估胰岛β细胞功能,分析血清GGT与胰岛β细胞功能的关系。结果:(1)稳态模型评估的胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、胰岛素曲线下面积(AUCINS)随着GGT水平的升高从Q1组到Q4组依次升高(P<0.01);(2)胰岛素敏感指数(ISI)随着GGT水平的升高从Q1组到Q4组依次下降(P<0.01);(3)GGT与HOMA-IR(rs=0.372)、HOMA-β(rs=0.369)、AUCINS(rs=0.359)、胰岛素30min增量(△I30)与血糖30 min增量(△G30)比值(△I30/△G30)(rs=0.201)呈正相关(均P<0.01);与ISI(rs=-0.326,P<0.01)呈负相关;(4)多元回归分析显示GGT为HOMA-IR的独立危险因子(P<0.05)。结论:2型糖尿病患者血清GGT水平对胰岛素抵抗及胰岛素分泌有一定影响。

Objective： To study the association of serum gamma-glutamyhransferase （GGT） concentration with islet β cell function in type 2 diabetic patients. Methods：A total of 240 cases with type 2 diabetes were divided into four groups according to GGT concentration quartile： group Q1 （GGT≤ 16.4 IU/L）, group Q2（ 16.4 IU/L 〈GGT≤26.4 IU/L）, group Q3（26.4 IU/L 〈GGT≤42.9 IU/L）, group Q4（GGT 〉 42.9 IU/L）, with 62, 59, 61, 58 patients respectively. The general clinical date of all patients were collected and the β cell function were evaluated to analyze the relationship between serum GGT and islet β cell function. Results： （1）Homeostasis model assessment of insulin resistance index （HOMA-IR）, islet β cell function index （HOMA-13）,area under curve of insulin （AUCINs） were elevated significantly and progressively from group Q1 to group Q4（P〈0.01 ）;（2）Insulin resistance index（ISI） decreased significantly and progressively from group Q1 to group Q4（P〈0.01 ）; （3）GGT was positively correlated with HOMA-IR（rs=0.372）, HOMA-13 （rs =0.369 ）, AUCINS（rs =0.359 ）, the ratio of insulin to glucose from 0 to 30 min （△I30/△G30） （rs =0.201 ）（P〈0.01）, but was negatively correlated with ISI （rs = -0.326,P〈0.01 ）;（4）Muhiple stepwise regression analysis showed that GGT was an independent risk factor of HOMA-IR （P〈0.05）. Conclusion：The serum GGT concentration in type 2 diabetic patients can influence insulin resistance and insulin secretion.