2型糖尿病患者血清钙与糖代谢的相关关系  

Correlation between serum calcium and glucose metabolism in patients with type 2 diabetes mellitus

作　　者：王珊珊[1] 陈莉明[1] 常宝成[1] 杨菊红[1] 徐延光[1] 郑妙艳[1] 王颖[1] 任惠珠[1] 赵然[1] 王晓宇[1] 单春艳[1] 

机构地区：[1]天津医科大学代谢病医院糖尿病肾科,卫生部激素与发育重点实验室,300070

出　　处：《中华内分泌代谢杂志》2014年第1期26-30,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金项目（81072922、81273915）;天津市卫生局科技基金（2011KZ89）

摘　　要：目的了解2型糖尿病患者血清钙与糖代谢的相关关系。方法肾功能正常的2型糖尿病患者302例按HbA1c水平分为3组：血糖控制较好组（HbA1c≤7．0％，96例），血糖控制一般组（7．0％〈HbA1c≤9．0％，134例），血糖控制差组（HbA1c〉9．0％，72例）。比较各组间血清校正钙浓度（CsCa）的差异，并对不同HbA1c水平下CsCa与胰岛素抵抗、胰岛β细胞功能、HbA1c空腹血糖等指标行相关和回归分析。结果（1）血糖控制差组CsCa[（2．26±0．12对2．22±0．09、2．21±0．11）mmoL／L]和碱性磷酸酶水平高于血糖控制较好、一般组（均P〈0．05），空腹胰岛素、稳态模型评估的胰岛β细胞功能指数（HOMA—β）均降低（均P〈0．05）。（2）在血糖控制较好组中，多元逐步回归分析显示，CsCa与股骨骨密度呈负相关（P〈0．01），与胰岛素敏感指数、总胆固醇呈正相关（P〈0．05）。（3）在血糖控制一般组中，稳态模型评估的胰岛素抵抗指数（HOMA—IR）与CsCa呈负相关（P〈0．01）。（4）在血糖控制差组中，多元逐步回归分析显示，CsCa与尿酸、HOMA—β呈负相关（P〈0．01），与HbA1c呈正相关（P〈0．01）。结论2型糖尿病患者CsCa与血糖控制状况、胰岛素抵抗、胰岛β细胞功能密切相关。Objective To investigate the correlation between serum calcium and glucose metabolism in patients with type 2 diabetes mellitus. Methods Three hundred and two cases of type 2 diabetics with normal renal function were divided into three groups according to their HbAic levels ： Better glycemic control group （ HbA1c ≥ 7.0% ）, moderate glyeemic control group （7.0% 〈 HbA1c ≤ 9.0% ） , and poor glycemie control group （HbA1c 〉 9.0% ）. Corrected serum calcium （CsCa） from the three groups were observed and compared and the correlation analysis and multiple stepwise regression were used to examine the correlations between CsCa and other indicators such as insulin resistance, pancreatic 13 cell function, HbAlc, and fasting plasma glucose. Results （ 1 ） Compared with better glycemic control group and moderate glycemic control group, the levels of CsCa L （2.26 ±0.12 vs 2.22±0.09, 2.21 ±0.11 ） mmol/L ] and alkaline phosphatase in poor glycemic control group were higher while the levels of fasting insulin and homeostasis model assessment of β cell function （ HOMA-β ） were significantly lower （ all P〈0.05 ）. （ 2 ） In better glycemic control group, C sCa was negatively correlated with femur bone mineral density （P 〈 0.01 ） and positively correlated with insulin sensitivity index and total cholesterol （ P 〈 0.05 ） by multiple stepwise regression analysis. （ 3 ） In moderate glycemic control group, CsCa was negatively correlated with homeostasis model assessment of insulin resistance index （ P〈0.01 ）. （4） In poor glycemic control group, multiple stepwise analysis indicated that CsCa was negatively correlated with uric acid and HOMA-β （P〈0.01） and positively correlated with HbA1c （P〈 0.01 ）. Conclusions CsCa is closely correlated with the levels of glycemic control, insulin resistance, and pancreatic β cell function in patients with type 2 diabetes mellitus.

关 键 词：血清校正钙浓度 胰岛Β细胞 HBA1C 糖尿病 2型 

分 类 号：R587.1[医药卫生—内分泌]