发病年龄对新诊断Ⅱ型糖尿病胰岛功能及相关指标的影响

Effect of age of onset on islet function and related indicators in newly diagnosed type Ⅱ diabetes

目的描述新诊断老年Ⅱ型糖尿病住院患者的临床基线特点并比较发病年龄对新诊断Ⅱ型糖尿病胰岛功能的影响。方法根据纳入标准2011年12月至2016年5月在武汉大学中南医院院内分泌科住院的新诊断Ⅱ型糖尿病患者,一项单中心横断面研究。根据发病年龄分为成年型糖尿病组和老年型糖尿病组,对两组的胰岛功能进行统计分析。结果共纳入272例,老年型糖尿病组103例(37.87%)。不同发病年龄下,老年型糖尿病组的收缩压、TG低于成年型糖尿病组, irt1h、irt2h、irt3h、AUCirt、胰岛素抵抗则高于成年型糖尿病组差异均无统计学意义(P>0.05)。两组在收缩压、体重指数、尿酸、CHOL、HDL、LDL、空腹血糖、ogtt 0.5h、ogtt 1h、ogtt 2h、ogtt 3h、AUCogtt、糖化血红蛋白、空腹胰岛素、irt 0.5h、AUCogtt/AUCirt、早相胰岛素分泌指数、HOMA-β的差异均无统计学意义(P>0.05)。结论相比成年型糖尿病,老年型糖尿病的胰岛素抵抗程度相对较重。

Objective To describe the clinical baseline characteristics of elderly patients with newly diagnosed type Ⅱ diabetes and to compare the effect of age at onset on islet function in newly diagnosed type Ⅱ diabetes. Methods According to the inclusion criteria, newly diagnosed type Ⅱ diabetes patients were admitted to Department of endocrinology in our hospital from December 2011 to May 2016, a single center cross-sectional study. According to the age of onset, it is divided into maturity-onset diabetes and senile diabetes group. We use statistical methods to analyze the islet function of the two groups. Results There were 272 cases, including 103 cases of elderly type diabetes group (37.87%). At different ages of onset, the systolic blood pressure and TG of the elderly type of diabetes group were lower than those of the adult type diabetes group, while his irt1h,irt2h, irt3h, AUCirt and insulin resistance were higher than those of the adult type diabetes group(P<0.05). Between the two groups, Systolic blood pressure, body mass index, uric acid, CHOL, HDL, LDL, fasting blood glucose, ogtt 0.5h, ogtt 1h, ogtt 2h, ogtt 3h, AUCogtt, glycosylated hemoglobin, fasting insulin, irt 0.5h, AUCogtt/AUCirt, early phase insulin secretion index, HOMA-βhad no significant difference (P>0.05). Conclusion Compared with maturity-onset diabetes, there is more severe insulin resistance in senile diabetes.