2型糖尿病患者胰岛功能与糖尿病肾病的相关性研究  

Study on the relationship between islet function and diabetes nephropathy in type 2 diabetes mellitus patients

作　　者：庄蕾[1] 苏建彬[2] 王春华[2] 朱锦 ZHUANG Lei;SU Jianbin;WANG Chunhua;ZHU Jin(Department of Endocrine,the Second People′s Hospital of Nantong,Jiangsu Province,Nantong 226002;Department of Endocrine,the Second Affiliated Hospital of Nantong University,the First People′s Hospital of Nantong,Jiangsu Province;Department of Science and Technology Division,Women′s Hospital of Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Jiangsu Province)

机构地区：[1]江苏省南通市第二人民医院内分泌科,南通226002 [2]南通大学第二附属医院,江苏省南通市第一人民医院内分泌科 [3]南京医科大学附属妇产医院,江苏省南京市妇幼保健院科技处

出　　处：《南通大学学报（医学版）》2022年第6期531-535,共5页Journal of Nantong University(Medical sciences)

基　　金：南通市卫健委基金资助项目(MB2020029);南通市社会民生科技计划面上资助项目(MS22022001)。

摘　　要：目的:探讨2型糖尿病患者的胰岛细胞功能与糖尿病肾病发生、发展的关系。方法:选取2018年1月—2020年7月间在南通市第一、第二人民医院内分泌科住院的早期糖尿病肾病期(AⅠ组)、临床糖尿病肾病期(AⅡ组)、不合并糖尿病肾病(B组)患者各50例为研究对象,对3组临床基线资料进行分析并对口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)后各时间点的血糖、胰岛素、胰高血糖素及C肽等胰岛功能指标进行分析。结果:AⅠ组的病程、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、糖化血红蛋白A1c(glycosylated hemoglobin A1c,HbA1c)等指标均显著高于B组(均P<0.05);而AⅠ组的年龄、病程、SBP、TC、LDL-C、HbA1c等指标均显著低于AⅡ组(均P<0.05)。OGTT结果显示,AⅠ组的血糖、胰高血糖素与胰岛素抵抗指数(insulin resistance index,HOMA-IR)等均显著高于B组(均P<0.05);而C肽、胰岛素和C肽/胰高血糖素均显著低于B组(均P<0.05)。AⅠ组的血糖、胰高血糖素与HOMA-IR均显著低于AⅡ组(均P<0.05);而C肽、胰岛素和C肽/胰高血糖素显著高于AⅡ组(均P<0.05)。多因素Logistic回归分析提示胰高血糖素曲线下面积(area under curve of glucagon,AUC胰高血糖素)与2型糖尿病肾病发生呈正相关(OR=1.665,95%CI:1.152~6.024,P<0.05)。结论:胰岛α、β细胞功能均与2型糖尿病肾病的发生、发展关系密切。Objective:To explore the relationship between islet cell function and the occurrence and development of diabetes nephropathy in type 2 diabetes mellitus patients.Methods:From January 2018 to July 2020,50 patients with early diabetes nephropathy(Group AⅠ),clinical diabetes nephropathy(Group AⅡ)and non diabetes nephropathy(Group B)who were hospitalized in the Endocrine Department of the First and Second People′s Hospital of Nantong were selected as the research objects.The clinical baseline data of the three groups of patients were analyzed,and the pancreatic islet function indexes such as blood glucose,insulin,glucagon and C-peptide at each time point after oral glucose tolerance test(OGTT)were analyzed.Results:The course of disease,systolic blood pressure(SBP),diastolic blood pressure(DBP),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),glycosylated hemoglobin A1c(HbA1c)and other indicators in Group AⅠwere significantly higher than those in Group B(all P<0.05).The age,course of disease,SBP,TC,LDL-C,HbA1c and other indexes in Group AⅠwere significantly lower than those in Group AⅡ(all P<0.05).OGTT results showed that blood glucose,glucagon and insulin resistance index(HOMA-IR)in Group AⅠwere significantly higher than those in Group B(all P<0.05).However,C-peptide,insulin and C-peptide/glucagon in Group AⅠwere significantly lower than those in Group B(all P<0.05).The blood glucose,glucagon and HOMA-IR in Group AⅠwere significantly lower than those in Group AⅡ(all P<0.05);C peptide,insulin and C peptide/glucagon were significantly higher than those in Group AⅡ(all P<0.05).Multivariate Logistic regression analysis showed that the area under the curve of glucagon(AUCglucagon)was positively correlated with type 2 diabetes mellitus nephropathy(OR=1.665,95%CI:1.152-6.024,P<0.05).Conclusion:Islet of pancreasα,βcell function is closely related to the occurrence and development of type 2 diabetes mellitus nephropathy.

关 键 词：2型糖尿病 糖尿病肾病 胰岛Α细胞 胰岛Β细胞 

分 类 号：R587.2[医药卫生—内分泌]