新诊断2型糖尿病患者糖化血红蛋白水平与胰岛β细胞功能指数的关系

Relationship Between Glycosylated Hemoglobin Level and Homeostasis Model Assessment forβCell Function in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

目的探讨新诊断2型糖尿病(T2DM)患者血清糖化血红蛋白(HbA1c)水平变化与胰岛β细胞功能指数(HOMA-β)的关系。方法选取2019年5月至2021年5月洛阳市第一人民医院95例新诊断T2DM患者,根据血清HbA1c水平将其分为3组(A组28例,B组31例,C组36例),比较3组血脂指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、血压[舒张压(DBP)、收缩压(SBP)]水平;比较3组胰岛素抵抗指数(HOMA-IR)、HOMA-β、胰岛素曲线下面积(AUC)、胰岛素与血糖净增值比值及空腹血糖(FPG)、餐后2 h血糖(2 h PG)、空腹胰岛素(FINS)、HbA1c水平;分析HbA1c、FPG、2 h PG、FINS水平变化与上述指标的关系。结果与A组、B组相比,C组TG、LDL-C、HDL-C水平较高(P<0.05);与A组、B组相比,C组血清FPG、2 h PG、FINS、HbA1c水平较高(P<0.05);与A组、B组相比,C组HOMA-β、AUC、ΔI/G较低(P<0.05);经Pearson相关性分析可知,HOMA-β、AUC、ΔI/G与血清FPG、2 h PG、FINS、HbA1c水平呈负相关,TG、LDL-C与血清FPG、2 h PG、FINS、HbA1c水平呈正相关(P<0.05);经多元线性回归分析,血清HbA1c、FINS、FPG水平为HOMA-β的重要影响因素(P<0.05)。结论T2DM患者随着血清HbA1c、FINS、FPG水平升高,胰岛β细胞分泌功能受损程度随之提高,临床可通过监测其水平评估胰岛β细胞分泌功能,为临床诊断、制定治疗方案提供可靠依据。

Objective To investigate the relationship between changes in serum glycated hemoglobin(HbA1 c)levels and homeostasis model assessment forβcell function(HOMA-β)in patients with newly diagnosed type 2 diabetes mellitus(T2 DM).Methods A total of 95 newly diagnosed T2 DM patients attending Luoyang First People’s Hospital from May 2019 to May 2021 were selected and divided into three groups according to serum HbA1 c levels(28 patients in group A,31 patients in group B,and 36 patients in group C).And the lipid indices[total cholesterol(TC),triglyceride(TG),low density liptein cholesterol(LDL-C),high density liptein cholesterol(HDL-C)],blood pressure[diastolic blood pressure(DBP),systolic blood pressure(SBP)]levels were compared among three groups.The homeostasis model assessment of insulin resistance(HOMA-IR),HOMA-β,area under the insulin curve(AUC),net insulin to glucose value-added ratio and fasting blood glucose(FPG),2-hours postprandial blood glucose(2 h PG),fasting insulin(FINS)and HbA1 c levels in the three groups were compared,and the relationship between the changes of HbA1 c,FPG,2 h PG and FINS levels and the above indicators were analyzed.Results Compared with groups A and B,group C had higher TG,LDL-C,HDL-C levels(P<0.05),and group C had higher serum FPG,2 h PG,FINS,HbA1 c levels compared with groups A and B(P<0.05).Group C had lower HOMA-β,AUC,ΔI/Gcompared with groups A and B(P<0.05).Pearson correlation analysis showed that HOMA-β,AUC,ΔI/Gwere negatively correlated with serum FPG,2 h PG,FINS and HbA1 c levels,and TG,LDL-C were positively correlated with serum FPG,2 h PG,FINS and HbA1 c levels(P<0.05).Multiple linear regression analysis showed that serum HbA1 c,FINS and FPG levels were influencing factors of HOMA-β(P<0.05).Conclusion In patients with T2 DM,as the levels of serum HbA1 c,FINS and FPG increase,the degree of impaired pancreaticβ-cell secretion function increases,and clinical assessment of pancreaticβ-cell secretion function can be made by monitoring their levels to provide a reliable basis for clinical diagnosis and treatment planning.