初发2型糖尿病患者糖化血红蛋白水平对胰岛素抵抗及胰岛功能的影响

目的探讨初发2型糖尿病（T2DM）患者糖化血红蛋白水平与胰岛功能的关系，为合理选择降糖药物和有效控制血糖提供理论依据。方法对新诊断的126例2型糖尿病患者（男76例，女50例）分别测量身高、体重、血脂、空腹血糖（FPG）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1C）。按HbA1C水平分为A组（HbA1C〈7．0％）、B组（7．0％≤HbAIC〈9．0％）及C组（HbA1C≥9．0％）3组，并分别计算胰岛素抵抗指数（HOMA—IR）、胰岛B细胞功能（HOMA—B）及胰岛索敏感性指数（ISI）。结果3组平均年龄和体重指数差异无统计学意义（P〉0．05）；随着HbA1C的增加，TG依次递增，HDL—C则依次递减。C组的FPG明显高于其他两组（P〈0．05）。B组表现为HOMA—IR明显增高，ISI下降。C组HOMA—B较其他两组明显降低，差异有统计学意义（P〈0．05）。结论初发2型糖尿病患者随着糖化血红蛋白的增高胰岛素敏感性下降，B细胞分泌能力减弱。

Effects of HbA1C on insulin resistance and islet function in newly diagnosed type 2 diabetic patients

Objective To provide theoretical support for for reasonable selection of hypoglyce- mic agents and effective control of blood glucose by investigating the relationship between HbA 1C level and islet function in newly diagnosed type 2 diabetic patients. Methods Height, body weight, blood lipids, fasting blood glucose and insulin, and HbA1C level were detected in 126 （ 76 male and 50 female ） newly diagnosed type 2 diabetic patients. The patients were then divided into group A （ HbA1C 〈 7.0% ）, group B （ 7.0% ≤ HbA1C 〈 9.0% ）, and group C （ HbA1C ≥ 9.0% ） based on HbA1C level. HOMA-IR, 14OMA-13, and ISI were determined. Results The mean age and BMI did not differ significantly among the three groups （ F 〉 0.05 ）. With an elevation in HbA1C, TC increased and HDL-C decreased accordingly. Fasting glucose level was significantly higher in group C than in groups A and B （ P〈 0.05 ）. HOMA-IR significantly increased and ISI declined in group B. As compared with other groups, HOMA- was significantly decreased in group C （ P 〈 0.05 ）. Conclusions With an increase in HbA 1C, the sensitivity to insulin declines level and β- cell function is weakened in newly diagnosed type 2 diabetic patients.