2型糖尿病患者空腹胰高糖素水平和胰高糖素/胰岛素比值随病程的演变  

Dynamics of fasting glucagon and fasting glucagon / insulin ratio with diabetes duration in patients with type 2 diabetes

作　　者：田萌[1] 武传龙[1] 齐林[1] 刘燕[1] 王川[1] 赵汝星[1] 梁凯[1] 宋君[1] 侯新国[1] 陈丽[1] 

机构地区：[1]山东大学齐鲁医院内分泌科,山东济南250012

出　　处：《山东大学学报（医学版）》2014年第11期33-37,共5页Journal of Shandong University:Health Sciences

基　　金：山东省医药卫生科技发展计划重点项目(2011HD005)

摘　　要：目的分析2型糖尿病患者空腹胰高糖素(FGLC)水平、空腹胰高糖素/胰岛素(FGLC/FINS)比值随病程进展的演变趋势及其与血糖控制水平的关系。方法选取2013年1月至2013年5月于山东大学齐鲁医院内分泌科住院的2型糖尿病患者262例,根据糖尿病病程分组如下:病程<5年为A组(65例),≥5年且<10年为B组(62例),≥10年且<15年为C组(46例),≥15年且<20年为D组(45例),≥20年为E组(44例),分析患者FGLC、空腹胰岛素(FINS)、FGLC/FINS比值、C肽、胰岛素抵抗指数(HOM A-IR)、胰岛素释放指数(HOM A-β)等指标与病程和空腹血糖(FBG)、糖化血红蛋白(Hb A1c)的相关性。结果 FGLC在A、B、C三组随病程逐渐升高(r=0.243,P<0.05),D、E组FGLC低于C组(P<0.05)且与病程无直线相关性;FGLC/FINS比值与病程呈显著正相关(r=0.243,P<0.05);多元线性逐步回归分析示,FGLC/FINS比值与FBG和Hb A1c呈正相关(t=4.474或2.212,P<0.05)。结论自诊断起15年内2型糖尿病患者FGLC随病程进展逐渐升高,此后出现轻度降低,FGLC/FINS比值随病程进展呈上升趋势;FGLC/FINS比值可能是影响2型糖尿病血糖控制水平的重要因素。Objective To analyze the dynamics of fasting glucagon （FGLC）and glucagon /insulin （FGLC/FINS）ra-tio with diabetes durations and their correlations with glycemic control in patients with type 2 diabetes.Methods Two hundred and sixty-two patients with type 2 diabetes were enrolled and divided into five groups according to diabetes duration：〈5 years （group A,n=65）;≥ 5 years and 〈10 years （group B,n=62）;≥10 years and 〈15 years （group C,n=46）;≥15 years and 〈20 years （group D,n=45）;≥20 years （group E,n=44）.FGLC,fasting insulin （FINS）,FGLC/FINS ratio,C peptide,HOMA-IR,HOMA-βand other metabolic indicators were measured to explore their correlations with diabetes duration,fasting blood glucose （FBG）and glycosylated hemoglobin （HbA1 c）. Results FGLC levels of groups A,B and C increased progressively with diabetes duration（r=0.243,P〈0.05 ）. Oppositely,FGLC levels of groups D and E were lower than that of group C （P〈0.05）and were not correlated with diabetes duration.FGLC/FINS ratio was positively correlated with diabetes duration （r=0.243,P〈0.05）.Multiple stepwise regression analysis showed that the FGLC/FINS ratio was positively correlated with FBG and HbA1 c （t=4.474 or 2.212,P〈0.05）.Conclusion FGLC of patients with type 2 diabetes increased with diabetes duration for＆nbsp;the first 15 years since being diagnosed,then slightly decreased,whereas the FGLC/FINS ratio consistently increased with diabetes duration.The FGLC/FINS ratio might significantly affect the glycemic control in patients with type 2 diabetes.

关 键 词：2型糖尿病 胰高糖素 胰高糖素/胰岛素比值 病程 

分 类 号：R587.1[医药卫生—内分泌]