德钦藏族初诊断2型糖尿病临床特点及糖化血红蛋白影响因素  

Clinical Characteristics of Newly Diagnosed Type 2 Diabetes Mellitus and Influencing Factors of Glycosylated Hemoglobin Among Tibetans in Deqin

作　　者：周琼[1] 彭葆坤[1] 翁晓春[1] 菊珍 孙诺批楚 唐哲[1] ZHOU Qiong;PENG Bao-kun;WENG Xiao-chun;JU Zhen;SUN Nuo-pi-chu;TANG Zhe(Dept.of Endocrinology,Yan'an Hospital Affilliated to Kunming Medical University,Kunming Yunnan,650051;Dept.of General Internal Medicine,People's Hospital of Deqin,Deqin Yunnan,674500,China)

机构地区：[1]昆明医科大学附属延安医院内分泌科,云南昆明650051 [2]德钦县人民医院内科,云南德钦674500

出　　处：《昆明医科大学学报》2021年第8期106-110,共5页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(2018FE001-277)。

摘　　要：目的探讨德钦藏族初诊断2型糖尿病患者的临床特点,分析糖化血红蛋白(HbA1c)的影响因素,了解高原藏族人群HbA1c与血红蛋白(Hb)的相关性。方法收集2018年5月到2020年6月德钦县医院体检和诊治的藏族患者120例的临床资料,依据血糖水平分为初诊断2型糖尿病组、糖尿病前期组和糖耐量正常组,比较3组之间一般资料及实验室指标间的差异。按血红蛋白水平,将研究对象分为高血红蛋白组及血红蛋白正常组,比较2组间空腹血糖、餐后2 h血糖及糖化血红蛋白的水平。对HbA1c与空腹血糖(FPG)、餐后2 h血糖(2 hPG)、血红蛋白进行多元线性回归分析。结果与糖耐量正常组相比,糖尿病组有更高的体重指数(BMI)、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL)和脂肪肝占比(P<0.05)。3组间性别、年龄、高血压占比、高密度脂蛋白(HDL)、尿酸(UA)、红细胞(RBC)及Hb,差异无统计学意义(P>0.05)。高血红蛋白组与正常血红蛋白组间空腹血糖、餐后2 h血糖及HbA1c,差异无统计学意义(P>0.05)。多元线性回归分析提示空腹血糖及餐后血糖均影响HbA1c,而Hb不是HbA1c的影响因素。回归方程为HbA1c=2.46+0.215×FPG+0.228×2 hPG(R2=0.73,P<0.05)。结论德钦藏族初诊断2型糖尿病患者有更高的BMI、TG、TC和脂肪肝占比,是早期识别糖尿病的线索。HbA1c的主要影响因素是空腹血糖和餐后2 h血糖,Hb不是HbA1c的影响因素。Objective To investigate the clinical characteristics of newly diagnosed type 2 diabetes mellitus(T2 DM) patients among Tibetans in Deqin,analyze the influencing factors of HbA1c,and explore the correlation between HbA1c and hemoglobin(Hb) in Tibetan population at high altitude. Methods Clinical data of 120 tibetan patients with medical examination or receiving diagnosis and treatment in People’s Hospital of Deqinfrom May 2018 to June 2020 were collected, and they were divided into three groups according to blood glucose level: newly diagnosed type 2 diabetes group, pre-diabetes group and normal glucose tolerance group. General data and laboratory indexes among the three groups were compared. According to hemoglobin level,the subjects were divided into high hemoglobin group and normal hemoglobin group. Fasting plasma glucose(FPG),two-hour postprandial plasma glucose( 2 hPG) and glycosylated hemoglobin( HbA1c) levels between the two groups were compared.The relationship between HbA1c and FPG, 2 hPG and Hb was analyzed by multiple linear regression.Results Comparedwith the normal glucose tolerance group,the diabetes group had higher body mass index(BMI),triglyceride(TG),cholesterol(TC),low density lipoprotein(LDL) and fatty liver ratio(P < 0.05). There were no significant differences in gender,age,hypertension,high density lipoprotein(HDL),uric acid(UA),red blood cell(RBC) and Hb among the three groups. There was no significant difference in FPG,2 hPG and HbA1c between the high hemoglobin group and the normal hemoglobin group(P > 0.05). Multiple linear regression analysis showed that both FPG and 2 hPG affected HbA1c,but Hb did not. The regression equation was y = 2.422 + 0.217 × FPG +0.227 × 2 hPG( R2 = 0.73, P < 0.05). Conclusion BMI, TG, TC and fatty liver in patients with newly diagnosed type 2 diabetes mellitus in Deqin Tibetan nationality is higher,which is a clue for early recognition of diabetes. The main influencing factors of HbA1c were FPG and 2 hPG. Hb was not the influencing factor of HbA1c.

关 键 词：2型糖尿病 高原 藏族 糖化血红蛋白 

分 类 号：R589.1[医药卫生—内分泌]