新诊断2型糖尿病患者餐后1h血糖与临床特征的相关性研究  

Correlation between one hour postload blood glucose and clinical characteristics in newly diagnosed type 2 dia⁃betes mellitus patients

作　　者：孙陆衍 张广吾[1] 周婷婷 蒋黎[2] 王芳[3] 史梦倩 范世宏[1] SUN Luyan;ZHANG Guangwu;ZHOU Tingting(Department of Endocrinology and Metabo-lism,Ningbo Medical Center Lihuili Hospital,Ningbo 315000,China.)

机构地区：[1]宁波市医疗中心李惠利医院内分泌科,浙江宁波315000 [2]宁波市医疗中心李惠利医院全科,浙江宁波315000 [3]宁波市医疗中心李惠利医院肾内科,浙江宁波315000

出　　处：《全科医学临床与教育》2024年第9期789-793,798,共6页Clinical Education of General Practice

基　　金：宁波市自然科学基金(2021J297);宁波市医疗中心李惠利医院博士科研启动项目基金(2022BSKY-SLY)。

摘　　要：目的探讨新诊断2型糖尿病患者餐后1 h血糖与临床特征的相关性。方法选取新诊断2型糖尿病患者201例,以OGTT试验1 h血糖值中位数为界,将患者分为低1 hPG组(100例)和高1 hPG组(101例),比较两组一般资料、生化指标及稳态模型指数,分析1 h血糖与临床特征的相关性,并探讨1 h血糖的影响因素。结果与低1 hPG组比较,高1 hPG组甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、糖化血红蛋白(HbA1c)、非酒精性脂肪性肝病(NAFLD)患病率、超敏C反应蛋白(hsCRP)及胰岛素抵抗指数(HOMA-IR)明显升高(Z分别=-3.41、-3.04、-2.43、-1.98、-2.45,t分别=-3.16、-2.37、-4.25,χ~2=16.50,P均<0.05),2 hCP、3 hCP及胰岛β细胞分泌指数(HOMA-β)明显降低(Z分别=-2.57、-2.12、-4.96,P均<0.05)。Spearman相关分析显示,1 h血糖与TG、TC、LDL、ALT、AST、HbA1c、hsCRP及HOMA-IR呈正相关(r分别=0.27、0.28、0.23、0.31、0.28、0.29、0.20、0.18,P均<0.05),与HOMA-β呈负相关(r=-0.44,P<0.05)。多元线性回归分析显示,TG、LDL、ALT、HOMA-β及HOMA-IR是1 h血糖的影响因素(t分别=2.17、3.05、5.73、-9.26、4.03,P均<0.05)。结论新诊断2型糖尿病患者餐后1 h血糖与血脂、肝功能、稳态模型指数及机体炎症反应水平相关,1 h血糖可以作为糖尿病血糖监测的一个新型指标。Objective To explore the correlationship between the one-hour postload plasma glucose(1 hPG)and the clinical characteristics of newly diagnosed type 2 diabetes mellitus(T2DM)patients.Methods Totally 201 newly diag⁃nosed T2DM patients were recruited and divided into low one-hour postload plasma glucose group(low 1 hPG group,n=100)and high one-hour postload plasma glucose group(high 1 hPG,n=101)based on the levels of one-hour postload plasma glucose.The clinical characteristics were compared between two groups.Spearman correlation was used to analyze the relationship between 1 hPG level and laboratory indicators.Multiple linear regression was used to analyze the factors affecting the changes of 1 hPG and 2 hPG levels.Results Compared with low 1 hPG group,the levels of TG,TC,LDL,ALT,AST,HbA1c,prevalence of NAFLD,hsCRP and HOMA-IR in high 1 hPG group were significantly higher(Z=-3.41,-3.04,-2.43,-1.98,-2.45,t=-3.16,-2.37,-4.25,χ2=16.50,P<0.05),and the levels of 2 hCP,3 hCP and HOMA-βin high 1 hPG group were significantly lower(Z=-2.57,-2.12,-4.96,P<0.05).Spearman correlation analysis showed that 1 hPG was positively correlated with TG,TC,LDL,ALT,AST,HbA1c,hsCRP and HOMA-IR(r=0.27,0.28,0.23,0.31,0.28,0.29,0.20,0.18,P<0.05),and negatively correlated with HOMA-β(r=-0.44,P<0.05).Multiple regression analysis showed that TG,LDL,ALT,HOMA-βand HOMA-IR were influenc⁃ing factors for 1 hPG(t=2.17,3.05,5.73,-9.26,4.03,P<0.05)in newly diagnosed T2DM patients.Conclusion The one-hour postload plasma glu⁃cose in newly diagnosed T2DM patients was correlat⁃ed with lipid profile,liver function,HOMA indeces and inflammation level,and it may be used as a new indicator for glu⁃cose monitor in diabetes patients.

关 键 词：2型糖尿病 餐后1 h血糖 非酒精性脂肪性肝病 超敏C反应蛋白 

分 类 号：R587.1[医药卫生—内分泌]