2型糖尿病患者HbA1c、25-OH-D3及T淋巴细胞亚群与胰岛素分泌的相关性分析  

The levels of HbA1c and 25⁃OH⁃D3 in patients with type 2 diabetes mellitus and the correlation between T lymphocyte subsets and insulin secretion

作　　者：付慧清 王新颜 吴洁清[2] 李燕[1] 李清 刘迎春 FU Huiqing;WANG Xinyan;WU Jieqing;LI Yan;LI Qing;LIU Yingchun(Department of Endocrinology,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang,Henan,China,453100;Department of Oncology,the First Affiliated Hospital of Xinxiang Medical Col-lege,Xinxiang,Henan,China,453100;College of Nursing,the First Affiliated Hospital of Xinxiang Medi-cal College,Xinxiang,Henan,China,453100)

机构地区：[1]新乡医学院第一附属医院内分泌科,河南新乡453100 [2]新乡医学院第一附属医院肿瘤内科,河南新乡453100 [3]新乡医学院第一附属医院护理学院,河南新乡453100

出　　处：《分子诊断与治疗杂志》2020年第12期1713-1716,1721,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省科技发展计划项目(192102311215)。

摘　　要：目的分析2型糖尿病(T2DM)患者糖化血红蛋白(HbA1c)、25-羟维生素D3(25-OH-D3)水平及T淋巴细胞亚群与胰岛素分泌的相关性。方法选取2019年5月至2020年5月本院收治的92例T2DM患者(观察组)及同期于本院体检正常者60例(对照组),收集所有研究对象一般资料,记录其HbA1c、25-OH-D3、T淋巴细胞亚群(CD4+、CD8+、CD4+/CD8+)水平及空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、胰岛素第一分泌时相峰值倍数情况,并采用葡萄糖负荷后30min的净增胰岛素与净增葡萄糖比值(⊿I30/⊿G30)来直面评估早相胰岛素分泌功能,比较两组组体质量指数(BMI)、血清HbA1c、25-OH-D3、T淋巴细胞亚群水平及胰岛分泌相关指标差异,采用Pearson相关分析分别观察T2DM患者血清Hb、25-OH-D3、T淋巴细胞亚群和胰岛分泌的关系。结果观察组HbA1c、CD8+水平显著高于对照组,而25-OH-D3水平、CD4+及CD4+/CD8+值显著低于对照组(P<0.05);观察组FBG、FINS、HOMA-β、HOMA-IR胰岛素第一分泌时相峰值倍数(PR)显著高于对照组,而⊿I30/⊿IG30显著低于对照组(P<0.05);T2DM患者血清HbA1c水平与FBG呈正相关,与FINS、HOMA-β、PR及⊿I30/⊿IG30呈负相关(P<0.05);T2DM患者血清25-OH-D3水平与FINS、HOMA-β、PR及⊿I30/⊿IG30呈正相关,与FBG及HOMA-IR呈负相关(P<0.05);T2DM患者CD8+、CD4+/CD8+与FBG、FINS、HOMA-β、HOMA-IR及PR均无显著相关性(P>0.05);而CD4+与FBG、HOMA-IR呈负相关,而与FINS、HOMA-β、PR及⊿I30/⊿IG30呈正相关(P<0.05)。结论 HbA1c、CD8+水平在T2DM患者中表达上升,而25-OH-D3、CD4+及CD4+/CD8+表达下降,且与胰岛素分泌具有密切相关性,联合三者检测有利于评估T2DM患者胰岛分泌功能。Objective To analyze the levels of Haemoglobin A1c(HbA1c)and 25⁃hydroxy vita⁃min D3(25⁃OH⁃D3)in patients with type 2 diabetes mellitus(T2DM)and analyze the correlation between T lymphocyte subsets and insulin secretion.Methods The clinical data of 92 T2DM patients(observation group)admitted to this hospital from August 2019 to May 2020 and 60 patients with normal physical examina⁃tion in this hospital(control group)during the same period were selected,and general data of all research sub⁃jects were collected.HbA1c,25⁃OH⁃D3,T lymphocyte subsets(CD4+,CD8+,CD4+/CD8+)levels and fast⁃ing blood glucose(FBG),fasting insulin(FINS),isletβcell function index(HOMA⁃β),the insulin resis⁃tance index(HOMA⁃IR),and the peak multiples of the first secretion phase of insulin are recorded.The ratio of net increase insulin to net increase glucose(⊿I30/⊿G30)at 30 min after glucose load was used to directly as⁃sess the insulin secretion function at early phase.The differences in body mass index(BMI),serum HbA1c,25⁃OH⁃D3,T lymphocyte subgroup levels,and related indexes of islet secretion between the control group and the observation group were compared.Pearson correlation analysis was used to observe the relationship between se⁃rum Hb,25⁃OH⁃D3,T lymphocyte subsets and islet secretion in T2DM patients.Results The HbA1c and CD8+levels of the observation group were significantly higher than those of the control group,while the 25⁃OH⁃D3 levels,CD4+and CD4+/CD8+values were significantly lower than those of the control group(P<0.05).The values of FBG,FINS,HOMA⁃β,HOMA⁃IR and the peak ratio of the first secretion phase of insulin(re⁃ferred to as peak ratio,PR)in the observation group were significantly higher than those in the control group,while⊿I30/⊿IG30 were significantly lower than those in the control group(P<0.05).Serum HbA1c levels in T2DM patients were positively correlated with FBG,and negatively correlated with FINS,HOMA⁃β,PR and⊿I30/⊿IG30(P<0.05).Serum 25⁃OH⁃D3 level

关 键 词：2型糖尿病 血红蛋白 25-羟维生素D3 T淋巴细胞亚群 胰岛素分泌 

分 类 号：R587.1[医药卫生—内分泌]