糖尿病合并肝脏损害患者胰岛素、C肽和血糖水平变化及临床意义研究

Study on the changes of insulin,C peptide and blood glucose levels in diabetic with liver damage patients and its clinical significance

目的探讨胰岛素、血糖及C肽联合检测对糖尿病合并肝脏损害的早期诊断价值。方法选取2014年1月至2016年1月该院收治的120例糖尿病患者分为糖尿病合并肝脏损害组(观察1组)53例和糖尿病肝功能正常组(观察2组)67例。另取同期在该院体检健康者50例作为对照组。检测各组患者空腹血糖(FBG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、餐后胰岛素(P2INS)、胰岛素抵抗指数(HOMA-IR)、C肽(CP)、餐后2hC肽(P2CP)水平,并分析各指标与肝脏损害的相关性。结果观察1组和观察2组FBG、2hPG、HbA1c、FINS、P2INS、HOMA-IR、CP、P2CP水平高于对照组,差异有统计学意义(P<0.05);观察1组各指标水平高于观察2组,比较差异有统计学意义(P<0.05);相关性分析显示糖尿病合并肝脏损害与FBG、2hPG、HbA1c、FINS、P2INS、CP、P2CP均呈正相关(r值分别为:0.274、0.190、0.220、0.230、0.195、0.083、0.289、0.724,P<0.05)。结论胰岛功能、血糖代谢在糖尿病合并肝脏损害的发病中起到重要作用,3种指标联合检测有助于早期诊断糖尿病合并肝脏损害。

Objective To explore the early diagnosis value of insulin,C peptide,blood glucose detection in diabetic patients withliver damage. Methods A total of 120 cases of diabetic patients were selected from January 2014 to January 2016 ？all of them weredivided into 53 cases of diabetes mellitus complicated with liver injury group （Study Group 1） and 67 cases of diabetes with normalliver function group （Study Group 2）, and 50 cases healthy people in the same period were selected as the control group, fastingblood glucose （FBG）,2 Hours Postprandial Blood Glucose （2hPG） , Glycosylated Hemoglobin （HbAlc） , fasting insulin （FINS）,2h postprandial fasting insulin （P2INS） ,homeostasis model assessment-insulin resistance index （HOMA-IR） ,c-peptide （CP） and （2hour postprandial fasting C peptide） P2CP levels of every group were detected？ and the correlation with indexes and liver damagewas analyzed. Results FBG,2hPG, HbAlc, FINS, P2INS, HOMA-IR, CP, P2CP levels in Study group 1 and Study Group 2 weresignificantly higher than those in the control group （P〈0.05） ,and each index level in Study group 1 was significantly higher thanthat in study Group 2（P〈0.05） ; correlation analysis showed that the diabetes mellitus combined with liver damage was positivelycorrelated with FBG, 2hPG, HbAlc, FINS, P2INS, CP, P2CP levels （r=0. 274,0. 190,0. 220,0. 230,0. 195,0. 083,0. 289,0. 724 re-spectively P〈0. 05）. Conclusion Pancreatic islet function and blood glucose metabolism play an important role in diabetic patients withliver damage,and three indexes combined detection can be used as early diagnosis of diabetes mellitus combined with liver damage.