【摘要】 目的 探讨2型糖尿病(T2DM)患者不同时间点C肽与胰岛素比值(C/I)同胰岛素抵抗(IR)的相关性，并建立一种新的胰岛素抵抗模型，探讨其对IR的预测价值。方法 收集2020年1月-2021年7月于新疆医科大学第一附属医院住院治疗的T2DM患者258例，分析T2DM患者各时间点C/I与IR的相关性；根据体质指数(BMI)将T2DM患者分为体重正常组、超重组、肥胖组，对3组间的0 min C/I、30 min C/I、120 min C/I、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)进行组间比较；建立一种新的胰岛素抵抗模型，研究新建立的胰岛素抵抗模型对IR的预测价值。结果 0 min C/I、30 min C/I、120 min C/I与HOMA-IR、HOMA-β均呈负相关；体重正常组、超重组和肥胖组3组间在0 min C/I、30 min C/I、120 min C/I、HOMA-IR、HOMA-β方面比较差异均有统计学意义。ROC曲线显示，新建立的胰岛素抵抗模型可用来预测IR,当HOMA-IR′为2.419(0 min C/I=0.277)时，对IR的预测价值最好，灵敏度为0.629,特异度为0.734,AUC曲线面积为0.756,95%CI为(0.694～0.818)。结论 T2DM患者的IR程度随着0 min C/I的升高而减轻，新建立的胰岛素抵抗模型可用来筛查IR。更多还原

【Abstract】 Objective To investigate the relationship between the ratio of C-peptide to insulin(C/I) at different time points and insulin resistance(IR) in patients with type 2 diabetes mellitus(T2DM), and to establish a new insulin resistance model to explore its predictive value for IR. Methods A total of 258 patients with T2DM who were hospitalized in the hospital from January 2020 to July 2021 were collected. The correlation between C/I and IR at different time points in T2DM patients were analyzed. According to BMI, the T2DM patients were divided into normal weight group, overweight group and obesity group, the 0 m C/I, 30 m C/I, 120 m C/I, HOMA-IR and HOMA-β among the three groups were compared. A new insulin resistance model was established to study the predictive value of the newly established insulin resistance model for IR. Results 0 min C/I, 30 min C/I, 120 min C/I were negatively correlated with HOMA-IR and HOMA-β in T2DM patients. There were significant differences in 0 m C/I, 30 m C/I, 120 m C/I, HOMA-IR and HOMA-β among normal weight group, overweight group and obesity group.The ROC curve showed that the newly established insulin resistance model can be used to predict IR. When HOMA-IR′ was 2.419(0 min C/I=0.277), it had the best predictive value for IR, with a sensitivity of 0.629, a specificity of 0.734, the area of AUC curve was 0.756, and the 95%CI was(0.694～0.818). Conclusion The degree of IR in T2DM patients decrease with the increasing of 0 m C/I. The newly established model of insulin resistance can be used to screen for IR.更多还原