2型糖尿病患者空腹胰高糖素水平和胰高糖素/胰岛素比值随病程的演变

doi:10.6040/j.issn.1671-7554.0.2014.194

摘要/Abstract

摘要： 目的分析2型糖尿病患者空腹胰高糖素(FGLC)水平、空腹胰高糖素/胰岛素(FGLC/FINS)比值随病程进展的演变趋势及其与血糖控制水平的关系.方法选取2013年1月至2013年5月于山东大学齐鲁医院内分泌科住院的2型糖尿病患者262例,根据糖尿病病程分组如下:病程<5年为A组(65例),≥5年且<10年为B组(62例),≥10年且<15年为C组(46例),≥15年且<20年为D组(45例),≥20年为E组(44例),分析患者FGLC、空腹胰岛素(FINS)、FGLC/FINS比值、C肽、胰岛素抵抗指数(HOMA-IR)、胰岛素释放指数(HOMA-β)等指标与病程和空腹血糖(FBG)、糖化血红蛋白(HbA1c)的相关性.结果 FGLC在A、B、C三组随病程逐渐升高(r=0.243,P<0.05),D、E组FGLC低于C组(P<0.05)且与病程无直线相关性;FGLC/FINS比值与病程呈显著正相关(r=0.243,P<0.05);多元线性逐步回归分析示,FGLC/FINS比值与FBG和HbA1c呈正相关(t=4.474或2.212,P<0.05).结论自诊断起15年内2型糖尿病患者FGLC随病程进展逐渐升高,此后出现轻度降低,FGLC/FINS比值随病程进展呈上升趋势;FGLC/FINS比值可能是影响2型糖尿病血糖控制水平的重要因素.

关键词: 胰高糖素/胰岛素比值, 胰高糖素, 2型糖尿病, 病程

Abstract: Objective To analyze the dynamics of fasting glucagon (FGLC) and glucagon /insulin (FGLC/FINS) ratio with diabetes durations and their correlations with glycemic control in patients with type 2 diabetes. Methods Two hundred and sixty-two patients with type 2 diabetes were enrolled and divided into five groups according to diabetes duration: <5 years (group A, n=65); ≥ 5 years and <10 years (group B, n=62); ≥10 years and <15 years (group C, n=46); ≥15 years and <20 years (group D, n=45);≥20 years (group E, n=44). FGLC, fasting insulin (FINS), FGLC/FINS ratio, C peptide, HOMA-IR, HOMA-β and other metabolic indicators were measured to explore their correlations with diabetes duration, fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c). Results FGLC levels of groups A, B and C increased progressively with diabetes duration(r=0.243, P<0.05). Oppositely, FGLC levels of groups D and E were lower than that of group C (P<0.05) and were not correlated with diabetes duration. FGLC/FINS ratio was positively correlated with diabetes duration (r=0.243, P<0.05). Multiple stepwise regression analysis showed that the FGLC/FINS ratio was positively correlated with FBG and HbA1c (t=4.474 or 2.212, P<0.05). Conclusion FGLC of patients with type 2 diabetes increased with diabetes duration forthe first 15 years since being diagnosed, then slightly decreased, whereas the FGLC/FINS ratio consistently increased with diabetes duration. The FGLC/FINS ratio might significantly affect the glycemic control in patients with type 2 diabetes.

Key words: Type 2 diabetes, Glucagon, Glucagon/insulin ratio, Duration

中图分类号:

R587.1

田萌, 武传龙, 齐林, 刘燕, 王川, 赵汝星, 梁凯, 宋君, 侯新国, 陈丽. 2型糖尿病患者空腹胰高糖素水平和胰高糖素/胰岛素比值随病程的演变[J]. 山东大学学报（医学版）, 2014, 52(11): 33-37.

TIAN Meng, WU Chuanlong, QI Lin, LIU Yan, WANG Chuan, ZHAO Ruxing, LIANG Kai, SONG Jun, HOU Xinguo, CHEN Li. Dynamics of fasting glucagon and fasting glucagon /insulin ratio with diabetes duration in patients with type 2 diabetes[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(11): 33-37.

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