老年T2DM患者HbA1c、FIns、HOMA-β及ISI检测及其诊断价值分析  

Detection of HbA1c, FIns, HOMA-beta and ISI in Elderly Patients with T2DM and Analysis of Their Diagnostic Value

作　　者：林亚毅 LIN Ya-yi(Department of Laboratory Medicine,Xianyue Hospital,Xiamen,Fujian Province,361001 China)

机构地区：[1]福建省厦门市仙岳医院检验科,福建厦门361001

出　　处：《中外医疗》2020年第3期184-186,共3页China & Foreign Medical Treatment

摘　　要：目的探讨老年2型糖尿病(T2DM)患者糖化血红蛋白(HbA1c)、空腹胰岛素(FIns)、胰岛素细胞功能指数(HOMA-β)及胰岛素敏感指数(ISI)检测及其诊断价值。方法方便选取2018年1月-2019年1月收治的老年T2DM患者130例,按照HbA1c水平的差异,分为A组(n=36)、B组(n=30)、C组(n=34)和D组(n=30),同时选取同期接受体检的健康者30名作为对照组。对FPG、TC、TG、FIns、2 hPG、2 hFIns进行测量,同时对OMA-β及ISI进行评估,对HbA1c与上述指标的相关性进行分析。结果相较于对照组,老年T2DM患者的HbA1c水平明显更高[(8.13±3.56)%vs(4.73±1.38)%,P<0.05];相较于对照组,老年T2DM患者的FPG、2 hPG、HOMA-IR、ISI和FIns更高,差异有统计学意义(P<0.05),HOMA-β更低,差异有统计学意义(P<0.05);C组和D组的FPG、2 hPG、FIns、ISI和TG水平高于A组和B组(P<0.05),2 hFIns和HOMA-β低于A组和B组,差异有统计学意义(P<0.05);A组、B组、C组和D组的HOMAIR,差异无统计学意义(P>0.05);相关性分析显示,老年T2DM患者HbA1c水平和FPG、2 hPG表现为明显正相关(r=0.685、0.788,P<0.05),和HOMA-β、FIns和ISI表现为明显负相关(r=-0.582、-0.541、-0.524,P<0.05)。结论老年T2DM患者机体HbA1c水平越高,血糖水平越高,则胰岛素敏感性将会明显降低,胰岛β细胞所具备的分泌能力也将会减弱。Objective To investigate the diagnostic value of glycosylated hemoglobin(HbA1 c), fasting insulin(FIns), insulin cell function index(HOMA-beta) and insulin sensitivity index(ISI) in elderly patients with type 2 diabetes mellitus(T2 DM).Methods 130 elderly T2 DM patients admitted from January 2018 to January 2019 were conveniently selected and divided into group A(n=36), group B(n=30), group C(n=34) and In group D(n=30), 30 healthy people who underwent physical examination during the same period were selected as the control group. FPG, TC, TG, FIns, 2 hPG, 2 hFIns were measured,while OMA-β and ISI were evaluated, and the correlation between HbA1 c and the above indicators was analyzed. Results Compared with the control group, the level of HbA1 c in elderly T2 DM patients was significantly higher [(8.13 ±3.56)% vs(4.73±1.38)%,P<0.05];compared with the control group, FPG of elderly T2 DM patients 2 hFPG, HOMA-IR,ISI and FIns were higher,the difference was statistically significant(P<0.05), HOMA-β and ISI were lower,the difference was statistically significant(P<0.05);group C and group D The levels of FPG, 2 hPG, FIns,ISI and TG were higher than those of group A and group B(P<0.05), 2 hFIns, and HOMA-β were lower than group A and group B,the difference was statistically significant(P<0.05);group A, group B, group C. There was no statistically significant difference between HOMA-IR and group D(P>0.05). Correlation analysis showed that HbA1 c levels were significantly positively correlated with FPG and 2 h PG in elderly T2 DM patients(r=0.685,0.788, P<0.05), and HOMA-β, FIns and ISI showed significant negative correlation(r=-0.582,-0.541,0.524, P<0.05). Conclusion The higher the level of HbA1 c and blood sugar in elderly patients with T2 DM,the lower the insulin sensitivity and the weaker the secretory capacity of islet beta cells.

关 键 词：2型糖尿病 老年 糖化血红蛋白 胰岛素 诊断价值 

分 类 号：R592[医药卫生—老年医学]