2型糖尿病患者胰岛素强化治疗后空腹C肽与铁蛋白变化的关系

CORRELATION BETWEEN FASTING C-PEPTIDE AND SERUM FERRITININ PATIENTS WITH TYPE 2 DIABETES MELLITUS TREATED BY CSII

目的探讨短期胰岛素泵强化治疗的2型糖尿病(type 2 diabetes mellitus,T2DM)患者空腹C肽(fasting C-peptide,FC-P)与血清铁蛋白(serum ferritin,SF)变化的相关性。了解胰岛素强化治疗后胰岛β细胞功能变化的影响因素,为临床评估患者胰岛β细胞功能寻找简便易行的方法。方法对305例T2DM患者行1周左右胰岛素泵治疗。记录血糖达标前、后SF,空腹血糖(fasting plasma glucose,FPG)及FC-P。结果胰岛素强化治疗后FC-P升高,FPG下降,SF随之改变。多因素线性逐步回归分析:ΔSF(血清铁蛋白变化量)、BMI(体重指数)、HbA1C(糖化血红蛋白)、病程是胰岛素强化治疗后FC-P的独立影响因素。FC-P与ΔSF呈负相关(r=0.651 t=-3.328,P<0.01)。结论 T2DM患者经短期胰岛素泵强化治疗后胰岛β细胞功能越好者,SF下降幅度越大。

Objective To investigate the correlation between fasting C-peptide(FC-P)and serum ferritin(SF)in type 2 diabetic patients(T2DM)treated by short-term continuous subcutaneous insulin infusion(CSII).To understand the influencing factors of islet beta cell function changes after intensive insulin therapy.To find a simple and easy method for clinical evaluation of isletβcell function.Methods A total of three hundred and five patients with T2DM in endocrinology department were enrolled in this study.All the subjects were treated with CSII about 1 week.SF,fasting plasma glucose(FPG),and FC-P were recorded before and after the blood sugar reached the standard.Results FC-P increased,FPG decreased and SF changed after intensive insulin therapy.Multivariate linear stepwise regression analysis showed that SF,BMI(body mass index),HbA1 C(glycosylated hemoglobin)and course of disease were independent influencing factors of FC-P after intensive insulin therapy.FC-P was negatively correlated with SF(r=0.651,t=3.328,P<0.01).Conclusion The better the function of isletβcells in patients with type 2 diabetes mellitus after short-term intensive insulin pump treatment,the greater the decrease of SF.