老年2型糖尿病患者血清C肽及胰岛素抵抗与脂质代谢及尿酸代谢的相关性  

Correlation of serum C-peptide and insulin resistance with lipid metabolism and uric acid metabolism in elderly patients with type 2 diabetes mellitus

作　　者：王志燕 赵平[2] 潘庆丰[1] 马军民 汪洋[1] Wang Zhiyan;Zhao Ping;Pan Qingfeng;Ma Junmin;Wang Yang(Department of Endocrinology,First People's Hospital of Wuhu City,Wuhu,Anhui,241000,P.R.China;Department of Orthopedics,First People's Hospital of Wuhu City,Wuhu,Anhui,241000,P.R.China)

机构地区：[1]安徽省芜湖市第一人民医院内分泌科,安徽芜湖241000 [2]安徽省芜湖市第一人民医院骨科,安徽芜湖241000

出　　处：《老年医学与保健》2022年第2期324-328,334,共6页Geriatrics & Health Care

基　　金：芜湖市卫生健康委员会科研项目(2017cg17)。

摘　　要：目的探究老年2型糖尿病(T2DM)患者血清C肽及胰岛素抵抗与脂质代谢、尿酸代谢的关系。方法回顾性分析2019年2月—2021年2月间安徽省芜湖市第一人民医院内分泌科收治的80例老年T2DM患者(设为T2DM组)的临床资料,选择同期体检的80例健康老年人作为对照组。T2DM组按照是否合并代谢综合症(MS)分为MS亚组(n=43)和非MS亚组(n=37)。收集所有研究对象的性别、年龄、病程等基线资料和实验室指标[空腹血糖(FPG)、HbA1c、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、空腹C肽(FC-P)、血尿酸(SUA)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)],分析FC-P及HOMA-IR与脂质代谢和尿酸代谢之间的关系,受试者工作特征曲线(ROC)评估FC-P和HOMA-IR水平对于老年T2DM患者合并MS的诊断效能。结果T2DM组患者FPG、HbA1c、TC、TG、LDL-C、SUA和HOMA-IR水平均高于对照组(P<0.05),HDL-C、FC-P和FINS水平低于对照组(P<0.05)。老年T2DM患者血清C肽和HOMA-IR与TC、TG、LDL-C和SUA均呈正相关关系(P<0.05),与HDL-C呈负相关关系(P<0.05)。与非MS亚组相比,MS亚组FPG、HbA1c、TC、TG、LDL-C、SUA和HOMA-IR水平升高(P<0.05),HDL-C、FC-P和FINS水平降低(P<0.05)。当FC-P水平高于1.23 ng/mL、HOMA-IR高于2.62时,对于老年T2DM患者合并MS的诊断效能最佳(P<0.05)。结论老年T2DM患者血清C肽及胰岛素抵抗与脂质代谢和尿酸代谢异常有关,FC-P和HOMA-IR水平可作为评估患者发生MS的有效指标。Objective To explore the correlation of serum C-peptide and insulin resistance with lipid metabolism and uric acid metabolism in elderly patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 80 elderly T2DM patients(T2DM group)treated in the Department of Endocrinology of First People’s Hospital of Wuhu City from February 2019 to February 2021 were analyzed retrospectively.80 healthy elderly people who underwent physical examination during the same period were selected as the control group.T2DM group was further divided into MS subgroup(n=43)and non-MS subgroup(n=37)according to whether the patients were complicated with metabolic syndrome(MS).The baseline data such as gender,age and disease course and laboratory indexes[fasting plasma glucose(FPG),HbAlc,total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),fasting C-peptide(FC-P),serum uric acid(SUA),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR)]of all research subjects were collected.The correlation of FC-P and HOMA-IR with lipid metabolism and uric acid metabolism was analyzed,and the receiver operating characteristic curve(ROC)was used to evaluate the efficacy of FC-P and HOMA-IR in the diagnosis of elderly T2DM patients with MS.Results The levels of FPG,HbAlc,TC,TG,LDL-C,SUA and HOMA-IR in the T2DM group were higher than those in the control group(P<0.05),while the levels of HDL-C,FC-P and FINS were lower than those in the control group(P<0.05).Serum C-peptide and HOMA-IR in elderly patients with T2DM were positively correlated with TC,TG,LDL-C and SUA(P<0.05),and negatively correlated with HDL-C(P<0.05).Compared with the non-MS subgroup,the levels of FPG,HbAlc,TC,TG,LDLC,SUA and HOMA-IR in the MS subgroup increased(P<0.05),while the levels of HDL-C,FC-P and FINS decreased(P<0.05).When the level of FC-P was higher than1.23 ng/mL and the HOMA-IR was higher than 2.62,the diagnostic efficiency for elderly T2DM patients with MS was th

关 键 词：老年 2型糖尿病 血清C肽 胰岛素抵抗 脂质代谢 尿酸代谢 

分 类 号：R587.1[医药卫生—内分泌]