2型糖尿病患者胰岛β细胞功能与血糖波动及不同血糖控制水平的相关性分析-现代医学

2型糖尿病患者胰岛β细胞功能与血糖波动及不同血糖控制水平的相关性分析

单位：安徽医科大学第三附属医院内分泌科, 安徽合肥 230061

分类号：R587.1

出版年·卷·期（页码）：2018·46·第二期（204-208）

摘要：

目的：分析2型糖尿病（T2DM）患者胰岛β细胞功能与其血糖波动及不同血糖控制水平的关系。方法：选取2016年至2017年在我院内分泌科住院的T2DM患者99例，患者入院后均行OGTT或100 g标准馒头餐试验，并监测患者的指尖血糖，计算日内血糖标准差（SDBG）表示患者的血糖波动，CPR index、SUIT、空腹C肽（FCP）、餐后2 h C肽（CP 2 h）表示患者的胰岛β细胞功能，分析血糖波动与胰岛β细胞功能的相关性。并根据糖化血红蛋白（HbA1c）水平将患者分为3组，分析3组之间胰岛β细胞功能的差异。结果：所选患者的CPRindex、SUIT0、SUIT120、FCP、CP 2 h分别与SDBG呈负相关性（r分别为-0.314、-0.274、-0.483、-0.245、-0.346，P分别为0.002、0.006、0.000、0.014、0.000）；随着血糖的升高，CPR index、SUIT0、SUIT120减小，FCP与CP 2 h水平减低，除SUIT0在7.5% < HbA1c≤10%组与HbA1c>10%组组间差异无统计学意义，FCP在HbA1c≤7.5%组与7.5% < HbA1c≤10%组组间差异无统计学意义，其它指标在各组间差异均有统计学意义（P < 0.05）。结论：T2DM患者的胰岛β细胞功能与血糖波动有着显著的相关性，血糖控制越差，胰岛β细胞功能也越差。

Objective: To analyze the relationship between islet β-cell function and glucose fluctuation and different glucose control levels in patients with type 2 diabetes mellitus(T2DM). Methods: 99 patients with T2DM from January 2016 to March 2017 in our institution were selected, all the patients received oral glucose tolerance test (OGTT) or 100 g standard steamed bread meal test, and the standard deviation of blood glucose (SDBG) was calculated according to the results of fingertip blood glucose monitoring, which indicateed the patient's glucose fluctuation. The patient's islet β-cell function was indicated in terms of CPR index with,SUIT,FCP,CP2h. The relationship of CPR index,SUIT,FCP,CP 2 h and SDBG were analyzed. The patients were divided into 3 groups according to their HbA1c level to analyze the difference of islet β-cell functionbetween the three groups. Results: The relationship of CPR index with SUIT0、SUIT120、FCP,CP 2 h and SDBG was negatively correlatied; CPR index,SUIT,FCP and CP 2 h are decreased with the increase of blood glucose. Conclusion: The pancreatic β-cell function and glucose fluctuation in patients with T2DM have a significant correlation, the worse the blood glucose control, the worse the islet β-cell function.

参考文献：

[1] WEYER C,BOGARDUS C,MOTT D M,et al.The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus[J].J Clin Invest,1999,104(6) 787-794.
[2] 吕丽芳,王椿,刘关键,等.自我血糖监测对预测糖调节异常者与糖尿病患者的日内血糖波动的价值[J].四川大学学报:医学版,2011,42(01):95-100.
[3] FUNAKOSHI S,FUJIMOTO S,HAMASAKI A,et al.Analysis of factors influencing pancreatic beta-cell function in Japanese patients with type 2 diabetes:Association with body mass index and duration of diabetic exposure[J].Diabetes Res Clin Pract,2008,82(3):353-358.
[4] YAMADA Y,FUKUDA K,FUJIMOTO S,et al.SUIT,secretory units of islets in transplantation:An index for therapeutic management of islet transplanted patients and its application to type 2 diabetes[J].Diabetes Res Clin Pract,2006,74(3):222-226.
[5] SAISHO Y,TANAKA K,ABE T,et al.Effect of obesity on declining beta cell function after diagnosis of type 2 diabetes:A possible link suggested by cross-sectional analysis[J].Endocr J,2012,59(3):187-195.
[6] LEAHY J L,HIRSCH I B,PETERSON K A,et al.Targeting beta cell function early in the course of therapy for type 2 diabetes mellitus[J].J Clin Endocrinol Metab,2010,95(9):4206-4216.
[7] TURNER R C,HOLMAN R R,CULL C A,et al.Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes(UKPDS 33).UK prospective diabetes study (UKPDS) group[J].Lancet 1998,352(9131):837-853.
[8] 申虎威,李燕,邢莉,等.血糖波动与糖尿病大血管病变的相关研究[J].中国病理生理杂志,2010,26(07):1311-1315.
[9] PALAZZO P,MAGGIO P,ALTAVILLAR,et al.Cerebral hemodynamics and systemic endothelial function are already impaired in well-controlled type 2 diabetic patients,with short-term disease[J].PLoS One,2013,8(12):e83287.
[10] 朱震宏,蒋晓真.2型糖尿病患者血糖波动与周围神经传导速度分析的观察[J].中国糖尿病杂志,2013,21(09):792-793.
[11] NAVARRO J F,MORA C.Role of inflammation in diabetic complications[J].Nephrol Dial Transplant,2005,20(12):2601-2604.
[12] DONATH M Y,SHOELSON S E.Type 2 diabetes as an inflammatory disease[J].Nat Rev Immunol,2011,11(2):98-107.
[13] EHSES J A,PERREN A,EPPLER E,et al.Increased number of islet-associated macrophages in type 2 diabetes[J].Diabetes,2007,56(9):2356-2370.
[14] BROWNLEE M.Biochemistry and molecular cell biology of diabetic complications[J].Nature,2001,414(6865):813-820.
[15] BROWNLEE M.The pathobiology of diabetic complications:A unifying mechanism[J].Diabetes,2005,54(6):1615-1625.
[16] DEFRONZO R A,TOBIN J D,ANDRES R.Glucose clamp technique:A method for quantifying insulin secretion and resistance[J].Am J Physiol,1979,237(3):E214-223.

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