2型糖尿病患者骨钙素与胰岛素抵抗、胰岛β细胞功能的相关性研究

目的分析2型糖尿病(T2DM)患者骨钙素(OC)与胰岛素抵抗、胰岛β细胞功能的相关性。方法测定60例T2DM患者(病例组)及20例正常人(正常对照组)的空腹血糖(FBG)、餐后2 h血糖(P2hBG)、空腹胰岛素(FINS)、空腹C肽(FCP)、糖化血红蛋白(HbA1c)、OC、脂联素(APN),用稳态模式胰岛素抵抗指数(HOMA-IR)评估胰岛素抵抗,用稳态模式胰岛素分泌指数(HOMA-B)及FCP评估胰岛β细胞功能状态。根据OC水平将病例患者分为两组,比较低骨钙素(OL)组与高骨钙素(OH)组上述指标的变化。结果病例组FINS、FCP、HOMA-B、OC、APN明显低于正常对照组,HOMA-IR、甘油三脂(TG)高于正常对照组(P<0.05)。OL组FBG、HbA1c、胆固醇(TC)、TG及HOMA-IR均高于OH组,但仅FBG、HbA1c差异有统计学意义(P<0.05);FINS、FCP、OC、APN及HOMA-B低于OH组,仅FCP、OC及APN差异有统计学意义(P<0.05)。相关回归分析显示,OC与FBG、HbA1c、HOMA-IR呈负相关,与FCP、FINS、APN及HO-MA-B呈正相关(P<0.05)。多元线性回归分析显示,OC与FCP呈独立正相关(P<0.05)。结论 T2DM患者血清OC水平的变化与胰岛素抵抗指数及胰岛β细胞功能指数的变化明显相关。

Osteocalcin,insulin resistance and β-cell function in type 2 diabetic patients:Acorrelative study

Objective To explore the relationship between serum osteocalcin level,insulin resistance and pancreatic β-cell function in type 2 diabetic patients.Methods Fasting blood glucose(FBG),past 2 hours blood glucose(P2hBG),fasting insulin(FINS),FCP,glycosylated hemoglobin(HbAlc),osteocalcin(OC) and adiponectin(APN)were measured in 60 cases of type 2 diabetic patients and 20 controls.Homeostasis model assessment for insulin resistance index(HOMA-IR) was used to evaluate insulin resistance,homeostasis model assessment for insulin secretion index(HOMA-B) and FCP were used to evaluate β-cell function.All the T2DM diabetics were divided into two groups: group OL and group OH.The differences of the indexs were compared between case group(OL) and normal group(OH) to reach the relativity of osteocalcin with insulin resistance and β-cell function in type 2 diabetic patients.Results FINS,FCP,HOMA-B,OC and APN were much more lower in patients compared with controls,whereas HOMA-IR and triglycercide(TG) were higher than those of controls(P<0.05).FBG,HbA1c,total cholesterol(TC),TG and HOMA-IR were all higher in OL group compared to OH group,in which only FBG and HbA1c had significantly difference(P<0.05).FINS,FCP,OC,APN and HOMA-B were lower in OL group compared to OH group,only FCP,APN and OC had significantly difference(P<0.05).There was significant negative correlation between OC with FBG,HbA1c and HOMA-IR,and significant positive correlation between OC with FCP,FINS,APN and HOMA-B(P<0.05).The multiple regression analysis showed that there was an independent positive correlation between OC and FCP(P<0.05).Conclusion There is significant correlation between OC with HOMA-IR and HOMA-B.