胰岛素、C肽、血糖对糖尿病合并肝脏损害中的早期预测价值  

Value of insulin, C-peptide and blood glucose detection in early diagnosis of diabetes with liver injury

作　　者：周荣佼[1] 王金燕[2] 

机构地区：[1]滨州医学院附属医院检验科,山东省滨州市256603 [2]滨州医学院附属医院疼痛康复二病区,山东省滨州市256603

出　　处：《世界华人消化杂志》2014年第27期4205-4209,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨胰岛素、血糖、C肽(C-peptide,CP)联合检测对糖尿病合并肝脏损害的早期诊断价值.方法:将滨州医学院附属医院收治的61例糖尿病合并肝脏损害患者作为研究组,同时选取55例糖尿病肝功能正常患者和50例健康人群分别作为对照组和正常组;比较3组血糖、胰岛素和CP水平.结果:研究组和对照组空腹血糖、餐后血糖水平均显著高于正常组(t=2.317,2.918,P<0.0 5),其中研究组空腹血糖(f a s t i n g blood-glucose,FBG)、餐后2 h血糖(2 hour postprandial blood glucose,2 h PBG)水平又显著高于对照组(t=3.084,4.431,P<0.05);研究组和对照组空腹胰岛素(fasting insulin,FINS)、餐后胰岛素(2 hour postprandial fasting insulin,P2INS)、空腹CP(fasting C peptide,CP)、餐后CP(2 hour postprandial fasting C peptide,P2CP)、胰岛素抵抗指数(insulin resistance index,HOMA-IR)水平均显著高于正常组(t=2.276,3.426,5.317,3.342,P<0.05);其中研究组各指标水平又显著高于对照组,两组间相比差异具有统计学意义(t=6.436,3.341,2.195,3.341,3.426,5.317,3.342,P<0.05).糖尿病合并肝脏损伤患者血糖水平与胰岛素、CP相关性呈正相关关系(r=0.589,0.724,P<0.05);3项联合检测能够显著提高诊断的敏感性和特异性分别为87.1%和94.8%,较单项检测显著提高.结论:胰岛素、血糖、CP联合检测可以作为糖尿病合并肝脏损害的早期诊断指标之一.AIM： To assess the value of insulin, C-peptide and blood glucose detection in the early diag- nosis of diabetes with liver damage.METHODS： Sixty-one liver injury treated at diabetic patients with our hospital were en- rolled as a study group, 55 diabetic patients with normal liver function as a control group, and 50 healthy people as a normal group. The levels of blood glucose, insulin and C-peptide among the three groups were compared.RESULTS： Fasting blood glucose and 2-hpostprandial blood glucose levels were sig- nificantly higher in the study group and control group than in the normal group （t = 2.317, 2.918, P 〈 0.05）, and in the study group than in the control group （t = 3.084, 4.431, P 〈 0.05）. Fasting insulin, 2-h postprandial fasting insulin, fasting C-peptide, 2-h postprandial C-peptide and insulin resistance index were significantly higher in the study group and control group than in the normal group （t = 2.276, 3.426, 5.317, 3.342, P 〈 0.05）, and in the study group than in the control group （t= 6.436, 3.341, 2.195, 3.341, 3.426, 5.317, 3.342, P 〈 0.05）. In diabetes patients with liver injury, blood glucose levels were positively corre- lated with insulin and C-peptide （r = 0.589, 0.724, P 〈 0.05）. The diagnostic sensitivity and specificity of combined detection of the three indexes were 87.1% and 94.8%, significantly higher than those of detection of any single index.CONCLUSION： Combined detection of blood glucose, insulin and C-peptide is helpful for early diagnosis of diabetes with liver injury.

关 键 词：胰岛素 C肽 血糖 糖尿病 肝损伤 

分 类 号：R587.1[医药卫生—内分泌]