2型糖尿病不同病程与胰岛功能及肾脏功能的相关研究

Correlation Study of Different Course of Type 2 Diabetes with Islet Function and Kidney Function

目的探讨2型糖尿病不同病程与胰岛素功能及肾脏功能的关系。方法回顾分析该院2019年1月—2020年1月收治的120例胰岛素泵治疗的2型糖尿病患者,依据病程分成4组:<1年(A组)、1~5年(B组)、5~10年(C组)及>10年(D组),观察各组患者临床特点、胰岛功能及肾脏功能指标,并分析病程与胰岛功能和肾脏功能的相关性。结果各组患者空腹血糖(FPG)、尿素氮(BUN)差异无统计学意义(P>0.05);A组糖化血红蛋白(HbA1c)、胰岛素抵抗指数(Homa-IR)较B、C、D组显著升高,差异有统计学意义(P<0.05);D组Homa-β、肾小球滤过率(eGFR)较A、B组显著降低,差异有统计学意义(P<0.05),D组(Cr)肌酐、β_(2)微球蛋白(β_(2)-MG)、尿蛋白肌酐比值(ACR)较A、B组显著升高,差异有统计学意义(P<0.05)。Pearson相关分析显示,病程与Cr、β_(2)-MG及ACR呈显著正相关(P<0.05);与eGFR、Homa-β及Homa-IR呈显著负相关(P<0.05)。结论2型糖尿病患者病程第1年胰岛素抵抗为主;病程第5年,肾脏功能显著受损;病程第10年,胰岛功能显著性下降,为临床及时干预,延缓病情进展提供理论依据。

Objective To investigate the relationship between different course of type 2 diabetes and insulin function and kidney function.Methods A retrospective analysis of 120 patients with type 2 diabetes treated with insulin pumps in the hospital from January 2019 to January 2020 were divided into 4 groups according to the course of the disease:<1 year(group A),1-5 years(group B),5-10 years(group C)and>10 years(group D),observed the clinical characteristics,islet function and renal function indexes of patients in each group,and analyzed the correlation between the course of the disease and the islet function and kidney function.Results There was no statistically significant difference in FPG and BUN between groups of patients;HbA1c and Homa-IR in group A were significantly higher than those in groups B,C,and D,the difference was statistically significant(P<0.05);Homa-β and eGFR in group D were significantly lower than those in groups A and B,the difference was statistically significant(P<0.05),Cr,β_(2)-MG,ACR in group D were significantly higher than those in groups A and B,the difference was statistically significant(P<0.05).Pearson correlation analysis showed that the course of the disease was significantly positively correlated with Cr,β_(2)-MG and ACR(P<0.05);and it was significantly negatively correlated with eGFR,Homa-βand Homa-IR(P<0.05).Conclusion The first year of the course of type 2 diabetes Insulin resistance is predominant;kidney function is significantly impaired in the 5th year of the disease;pancreatic islet function declines significantly in the 10th year of the disease,providing a theoretical basis for timely clinical intervention and delaying the progression of the disease.