2型糖尿病患者血钾水平与胰岛素抵抗及胰岛功能的关系

Relationship between serum potassium and insulin resistance and islet function in patients with type 2 diabetes

目的探讨T2DM患者血钾水平与IR和胰岛β细胞功能的关系。方法选取256例新诊断T2DM患者,均行75g OGTT,收集空腹血样本及糖负荷后30min、120min血样本,并对入选者行问卷调查、体格检查、胰岛素及血钾相关指标的测定,计算评价IR的参数[胰岛素抵抗指数(HOMA-IR)、Matsuda指数]和胰岛β细胞功能的参数(DI0、DI30、DI120)。结果在T2DM中,HOMA-IR与BMI、TC、TG呈正相关,与血钾呈负相关(P<0.05),Matsuda指数与BMI、TC、TG呈负相关,与血钾呈正相关(P<0.05),DI0与TC、LDL-C呈负相关(P<0.05),DI30与TC、TG、LDL-C呈负相关(P<0.05),DI120与TC、TG、LDL-C呈负相关,与血钾呈正相关(P<0.05)。多元线性回归分析显示,校正血脂、年龄等因素后,血钾是HOMA-IR、Matsuda指数、DI120的独立危险因素。结论在T2DM中,血钾水平与HOMA-IR及胰岛β细胞功能密切相关。

Objective To explore the relationship between serum potassium and insulin resistance and isletβcell function in patients with type 2 diabetes（T2DM）. Methods A total of 256 patients with newly diagnosed T2 DM were enrolled in this study.All patients underwent 75 g OGTT.Blood samples were collected at baseline,30 min and 120 min after glucose load.Questionnaires and physical examination were done in all patients.Serum potassium and insulin level were measured.Insulin resistance was calculated by HOMA-IR and Matsuda index.Isletβcell function was measured by DI0,DI30 and DI120.Results In T2 DM patients,HOMA-IR was positively correlated with BMI,TC and TG,and negatively correlated with serum potassium（P〈0.05）.Matsuda index was negatively correlated with BMI,TC and TG and positively correlated with serum potassium（P〈0.05）.DI0 was negatively correlated with TC and LDL-C（P〈0.05）.DI30 was negatively correlated with TC,TG and LDL-C（P〈0.05）.DI120 was negatively correlated with TC,TG and LDL-C,and positively correlated with serum potassium（P〈0.05）.Multiple linear regression analysis showed that serum potassium was independent risk factor for HOMAIR,Matsuda index and DI120 after adjusting serum lipid and age. Conclusion In T2 DM patients,serum potassium is significantly correlated with insulin resistance and isletβcell function.