2型糖尿病患者血清胰岛素及C肽释放水平变化的临床研究

Clinical Study on the Changes of Serum Insulin and C-peptide Release Levels in Patients With Type 2 Diabetes

目的探究2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清胰岛素与C肽释放水平变化的临床意义。方法选择阳江市人民医院2019年5月—2020年12月收治的T2DM患者100例为研究对象,设定为T2DM组;选择同期到院进行健康体检的健康者100例,设定为健康组。两组首次采血后给予标准馒头餐,从进食开始计算时间,分别于0.5 h、1 h、2 h、3 h再次采血比较各个时点血清胰岛素与C肽水平。结果餐前、0.5 h、1 h、2 h、3 h时T2DM组血糖水平高于健康组,差异有统计学意义(P<0.05)。餐前两组血清胰岛素水平比较,差异无统计学意义(P>0.05),0.5 h、1 h、2 h时T2DM组血清胰岛素水平低于健康组,3h时T2DM组血清胰岛素水平高于健康组,差异有统计学意义(P<0.05);餐前两组C肽水平比较,差异无统计学意义(P>0.05),0.5h、1h、2h时T2DM组C肽水平低于健康组,3h时T2DM组C肽水平高于健康组,差异有统计学意义(P<0.05)。结论餐前血清胰岛素与C肽水平在T2DM与正常人群中无明显差异,但从进餐0.5 h开始,T2DM患者血清胰岛素、C肽水平均低于正常人群,且至餐后3 h仍无法恢复正常。血清胰岛素与C肽水平可作为T2DM临床判断病情严重程度的科学指标。

Objective To explore the clinical significance of changes in serum insulin and C-peptide release levels in patients with type 2 diabetes mellitus(T2DM).Methods A total of 100 T2DM patients admitted to Yangjiang People’s Hospital from May 2019to December 2020 were selected as the research object and set as the T2DM group;100 healthy patients who were in the hospital for physical examination during the same period were selected as the healthy group.After the first blood sampling,the two groups were given a standard steamed bread meal.The time was calculated from the start of the meal,and blood was collected again at 0.5 h,1 h,2 h,and 3 h to compared the serum insulin and C-peptide levels at each time point.Results The blood glucose levels in the T2DM group were higher than those in the healthy group before meals,0.5 h,1 h,2 h,and 3 h,and the differences were statistically significant(P<0.05).There was no significant difference in serum insulin levels between the two groups before meals(P>0.05).The serum insulin level in the T2DM group was lower than that in the healthy group at 0.5 h,1 h and 2 h,and the serum insulin level in the T2DM group was higher than that in the healthy group at 3 h.The difference was statistically significant in the two groups(P<0.05);there was no significant difference in C-peptide levels between the two groups before meals(P>0.05).The level of C-peptide in the T2DM group was lower than that in the healthy group at 0.5 h,1 h,and 2 h.At 3 h,the level of C-peptide in the T2DM group was higher than that in the healthy group,and the difference was statistically significant(P<0.05).Conclusion There is no significant difference between pre-meal serum insulin and C-peptide levels in T2DM and normal people.However,the serum insulin and C-peptide levels of T2DM patients are lower than those of normal people from 0.5 h after meal,and they still cannot return to normal at 3 h after meal.Serum insulin and C-peptide levels can be using as scientific indicators for clinical judgment of the severity of T2DM.