老年女性2型糖尿病病人血清肌酐/胱抑素C比值与胰岛B细胞功能的相关性研究

Correlation between serum creatinine/cystatin C ratio and islet beta-cell function in elderly women with type 2 diabetes mellitus

目的探讨老年女性2型糖尿病病人血清肌酐/胱抑素C比值(Cr/Cys-C)与胰岛B细胞功能的相关性。方法选择年龄≥65岁的老年女性T2DM病人180例,收集临床资料,行75 g口服葡萄糖耐量试验(OGTT),计算胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)、葡萄糖处置指数(DI)。根据Cr/Cys-C三分位数将病人分为3组,比较3组间胰岛B细胞功能指标。采用相关分析评估Cr/Cys-C与各胰岛功能指标的相关性。结果Cr/Cys-C第三分位组、第二分位组的InsAUC30、InsAUC120、HOMA-β、DI30均高于第一分位组,BMI、腰围、HbA1c水平均低于第一分位组,差异具有统计学意义(P<0.05)。Cr/Cys-C与空腹血清胰岛素(r=0.187,P=0.005)、InsAUC30(r=0.268,P<0.001)、InsAUC120(r=0.216,P=0.002)、HOMA-β(r=0.279,P<0.001)、DI30(r=0.245,P<0.001)、DI120(r=0.183,P=0.005)均呈正相关。校正了年龄、BMI、病程、HbA1c后,上述相关性仍存在(P<0.05)。结论老年女性T2DM病人血清Cr/Cys-C水平与胰岛B细胞功能之间存在正相关关系。

Objective To investigate the correlation between serum creatinine/cystatin C ratio(Cr/Cys-C)and pancreaticβ-cell function in the elderly female patients with type 2 diabetes mellitus(T2DM).Methods A total of 180 elderly female patients with T2DM aged≥65 years were enrolled,and the general clinical data were collected.All patients underwent 75 g oral glucose tolerance test(OGTT),and insulin resistance index(HOMA-IR),insulin secretion index(HOMA-β)and glucose disposal index(DI)were calculated.All patients were divided into three groups according to the tri-sectional quantiles of Cr/Cys-C and the above indexes were compared.The relationship between Cr/Cys-C and indicator ofβ-cell function was analyzed.Results Compared to the lower tertile group,InsAUC30,InsAUC120,HOMA-βand DI30 were significantly higher,and the levels of body mass index(BMI),waist circumference and HbA1c were significantly lower in the middle tertile group and the upper tertile group(P<0.05).Cr/Cys-C was positively correlated with fasting serum insulin(FINS)(r=0.187,P=0.005),InsAUC30(r=0.268,P<0.001),InsAUC120(r=0.216,P=0.002),HOMA-β(r=0.279,P<0.001),DI30(r=0.245,P<0.001)and DI120(r=0.183,P=0.005).After adjusting age,BMI,disease duration and HbA1c,these correlations were still present(P<0.05).Conclusions There is a positive correlation between serum Cr/Cys-C and pancreaticβ-cell function in the elderly female patients with T2DM.