【摘要】 目的 :探讨影响残存胰岛 β细胞功能 (BF)的因素。 方法 :调查 2 96名 2型糖尿病患者发病时年龄、空腹血糖 (FPG)、体重及最高体重、目前体重等临床资料。根据发病时FPG水平将患者分为 4组 (<7.0 ,7.0～10 .0 ,10 .0～ 12 .2 ,≥ 12 .2mmol/L)。入院后测定患者FPG、胰岛素 (FINS)、血脂及标准馒头餐 (10 0g)后 1h、2h血糖和胰岛素。β细胞功能用HOMA β公式 [2 0×FINS/(FPG -3 .5 ) ]计算 ,胰岛素抵抗指数用HOMA IR公式 (FINS×FPG/2 2 .5 )计算。用一般多元线性回归模型分析影响BF的因素。结果 :随患者发病时FPG水平的升高 ,FINS、BF显著下降 (P <0 .0 5 )。多元线性回归分析显示 :在调整年龄、性别、病程、血脂后 ,BF与发病时FPG独立负相关 (P <0 .0 5 ) ,与胰岛素抵抗指数呈正相关 (P <0 .0 1)。结论 :2型糖尿病患者发病时的FPG水平可预示未来β细胞功能状态 ,特别是发病时FPG≥ 12 .2mmol/L的患者 ,β细胞功能衰竭更快更多还原

【Abstract】 Objective:To evaluate the impact of the fasting plasmic glucose (FPG) at onset of diabetes mellitus(DM) on the residual beta cell function (BF) in type 2 diabetic patients.Methods:A consecutive cohort of 296 type 2 diabetic patients were divided into four groups(Q1 Q4) according to the onset FPG levels (<7.0, 7.0 10.0, 10.0 12.2,≥12.2 mmol/L,respectively),whose clinical data of the duration of DM,the onset FPG,weight were collected. The levels of postprandial blood glucose and insulin (INS) after a standard meal load were determined,as well as the levels of the present FPG, fasting plasmic INS (FINS), and lipid. Insulin resistance (IR) and the BF were assessed by the HOMA IR formula (FINS×FPG/22.5) and the HOMA β formula [20×FINS/(FPG-3.5)],respectively.Results:The residual BF and FINS had a decreasing trend with the increase of the onset FPG. The BF and FINS in Q4 were significantly lower than that in Q1, Q2, and Q3. General linear regression model analysis showed that the BF was negatively correlated with the group of the onset FPG≥12.2 mmol/L but positively with IR after adjustment to age, duration of DM and sex.Conclusion:Our preliminary data support the hypothesis that the onset FPG is a predictor of the residual beta cell function in the future.更多还原