合并不同慢性并发症的2型糖尿病患者血清胰岛素、糖化血红蛋白水平及其临床意义

Serum insulin and hemoglobin A1c levels of type 2 diabetes mellitus patients with different chronic complications and its clinical significance

目的探讨合并不同慢性并发症2型糖尿病(T2DM)患者血清胰岛素(Ins)、糖化血红蛋白(Hb A1c)的水平及其临床意义。方法选取无并发症的T2DM患者62例(对照组)及存在不同并发症的T2DM患者143例,后者包括41例合并糖尿病肾病(糖尿病肾病组)、65例合并周围神经病变(周围神经病变组)、37例合并多种并发症(多发并发症组)。所有患者进行口服葡萄糖耐量试验(OGTT)及Ins释放试验,并检测Hb A1c水平。结果 4组间OGTT结果及Hb A1c水平比较,差异无统计学意义(P>0.05)。糖尿病肾病组空腹胰岛素(FIns)水平高于其他3组(P<0.05),周围神经病变组FIns水平低于其他3组(P<0.05);糖尿病肾病组、对照组、周围神经病变组、多发并发症组的餐后0.5 h Ins及餐后1 h Ins依次降低(P<0.05);糖尿病肾病组、周围神经病变组、对照组、多发并发症组的餐后2 h Ins依次降低(P<0.05)。结论合并不同慢性并发症T2DM患者的血清Ins水平存在差异,但其Hb A1c水平并无差异,检测Ins水平可能对T2DM慢性并发症的评估及治疗具有重要意义。

Objective To investigate the serum insulin（Ins） and hemoglobin A1c（Hb A1c） levels of type 2 diabetes mellitus（T2DM）patients with different chronic complications and its clinical significance. Methods Sixty-two T2 DM patients without any complications（control group） and 143 T2 DM patients with different complications were enrolled,and the latter patients consisted of 41 patients complicated with diabetic nephropathy（DN group）,65 patients with peripheral neuropathy（PN group） and 37 patients with multiple complications（multiple complications group）. Oral glucose tolerance test（OGTT）,Ins release test and Hb A1 c detection were performed in all patients. Results There were no significant differences in OGTT result or Hb A1 c level among the four groups（P〉0. 05）. The fasting insulin（FIns） level of the DN group was higher than those in the 3 other groups（P〈0. 05）,and the Fins level of the PN group was lower than those in the other3 groups（P〈0. 05）. The 0. 5-and 1-hour postprandial insulin levels decreased in the order of DN group,control group,PN group and multiple complications group（P〈0. 05）. The 2-hour postprandial insulin level decreased in the order of DN group,PN group,control group and multiple complications group（P〈0. 05）. Conclusion Difference in serum Ins level exists in T2 DM patients with different chronic complications,but no difference in their Hb A1 c level. It is important to detect serum Ins level for evaluating and treating chronic complications of T2 DM patients.