新诊断2型糖尿病患者不同HbA1c水平胰岛α及β细胞功能评价

发布时间：2018-01-14 18:19

本文关键词：新诊断2型糖尿病患者不同HbA1c水平胰岛α及β细胞功能评价　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:了解新诊断2型糖尿病(T2DM)患者不同糖化血红蛋白(Hb A1c)水平胰岛α、β细胞功能状况。方法:采用临床回顾性分析的方法,选取新诊断T2DM患者269例,根据HbA1c水平将新诊断T2DM患者分为A、B、C、D组,进行口服葡萄糖耐量试验(OGTT)、胰岛素释放、胰高血糖素释放试验,比较各组稳态模型评估的胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、早时相胰岛素分泌指数(△I30/△G30)、第二时相胰岛素分泌指数[胰岛素曲线下面积(AUC_(Ins))]、胰高血糖素、胰高血糖素/胰岛素、胰高血糖素曲线下面积(AUCglu)等指标,分析Hb A1c与胰岛α及β细胞功能的关系,评估各组胰岛α及β细胞功能。结果:(1)HbA1c与胰岛β细胞的分泌及抵抗有良好的相关性(均p0.05),和胰岛α细胞无明显相关性(p0.05)。(2)随着HbA1c水平的升高,HOMA-β、△I30/△G30、AUC_(Ins)均明显降低(均p0.05),HOMA-IR有明显差异(p0.05),但未见明显趋势。随着HbA1c水平的升高,胰岛α细胞分泌的胰升糖素绝对值无明显差异(p0.05),但胰升糖素/胰岛素比值明显增高,差异有统计学意义(p0.05)。结论:新诊断2型糖尿病患者HbA1c与胰岛β细胞的分泌及抵抗有良好的相关性,和胰岛α细胞无明显相关性。随着Hb A1c水平的升高,新诊断2型糖尿病患者胰岛β细胞分泌功能逐渐减弱,胰岛素各时相分泌减少,胰升糖素绝对值虽无明显变化,但胰升糖素/胰岛素比值逐渐增大,两者比例失调加剧了2型糖尿病患者血糖的升高。
[Abstract]:Objective: to investigate the function of islet 伪 and 尾 cells in patients with newly diagnosed type 2 diabetes mellitus (T2DM) at different levels of HbA1c. methods: clinical analysis was performed retrospectively. Two hundred and sixty-nine newly diagnosed T2DM patients were divided into two groups according to HbA1c level. Oral glucose tolerance test (OGTT) and insulin release were performed. Glucagon release test was performed to compare the insulin resistance index (HOMA-IRI) and islet 尾 cell function index (HOMA- 尾). Early phase insulin secretion index (I 30 / G 30), second phase insulin secretion index (I 30 / G 30). [Area under insulin curve (AUC), glucagon, glucagon / insulin, and area under glucagon curve were measured. The relationship between HbA1c and islet 伪 and 尾 cell function was analyzed. Results there was a good correlation between HbA1c and the secretion and resistance of islet 尾 cells (all p0.05). There was no significant correlation between Homa 尾, I 30 / G30 with the increase of HbA1c level. There was a significant difference in HOMA-IR between the two groups, but there was no obvious trend. With the increase of HbA1c level, there was no obvious trend. There was no significant difference in the absolute value of glucagon secreted by islet 伪 cells, but the ratio of glucagon to insulin was significantly increased. Conclusion: there is a good correlation between HbA1c and the secretion and resistance of islet 尾 cells in newly diagnosed type 2 diabetic patients. With the increase of HbA1c level, the 尾 -cell secretory function of the newly diagnosed type 2 diabetes mellitus gradually decreased, and the secretion of insulin decreased at different time stages. Although the absolute value of glucagon did not change obviously, the ratio of glucagon to insulin gradually increased. The imbalance of the ratio of glucagon and insulin aggravated the increase of blood glucose in patients with type 2 diabetes mellitus.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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