CAJ | 학술논문

目的探讨新诊断2型糖尿病患者糖化血清白蛋白(GA)与胰岛β细胞功能的关系.方法研究对象来自于2008年1月至2010年10月为明确糖尿病(DM)诊断而就诊者和DM高危人群接受筛查者,受检者均行75 g口服葡萄糖耐量试验(OGTT)及胰岛素释放试验,采用液态酶法测定GA水平,采用高压液相法测定糖化血红蛋白(HbAlc)水平.以稳态模式分析法(HOMA)评价基础胰岛素抵抗(HOMA-IR)和胰岛β细胞分泌功能(HOMA-β);以胰岛素增量与葡萄糖增量比值(△I30/△G30)评估糖负荷后早期相胰岛素分泌.结果 (1)按1999年WHO糖尿病诊断标准,经OGTT诊断为2型DM的500例患者中,男279例、女221例.平均年龄(56.3±12.3)岁,GA为(21.1±5.4)％,HbAlc为(7.0±1.3)％,HOMA-β为(男:98±63)％(女:121 ±80)％.(2)GA与HbAlc之间有良好的相关性(r=0.691,P＜0.01).GA与OGTT中空腹血糖(FPG,糖负荷后0.5、1、2和3h的各点血糖均呈正相关(r值为0.511～0.627,均P＜0.01).(3)GA与体质指数呈负相关(r=-0.112,P＜0.01).GA与HOMA-β、△I30/△G30呈负相关(r值分别为-0.350、-0.263,均P＜0.01).(4)多元逐步回归分析,显示HbAlc、FPG、糖负荷后3h血糖及△I30/△G30是影响GA的主要因素.结论新诊断2型DM患者GA水平与早期相胰岛素分泌功能密切相关.
목적 탐토신진단2형당뇨병환자당화혈청백단백(GA)여이도β세포공능적관계.방법 연구대상래자우2008년1월지2010년10월위명학당뇨병(DM)진단이취진자화DM고위인군접수사사자,수검자균행75 g구복포도당내량시험(OGTT)급이도소석방시험,채용액태매법측정GA수평,채용고압액상법측정당화혈홍단백(HbAlc)수평.이은태모식분석법(HOMA)평개기출이도소저항(HOMA-IR)화이도β세포분비공능(HOMA-β);이이도소증량여포도당증량비치(△I30/△G30)평고당부하후조기상이도소분비.결과 (1)안1999년WHO당뇨병진단표준,경OGTT진단위2형DM적500례환자중,남279례、녀221례.평균년령(56.3±12.3)세,GA위(21.1±5.4)％,HbAlc위(7.0±1.3)％,HOMA-β위(남:98±63)％(녀:121 ±80)％.(2)GA여HbAlc지간유량호적상관성(r=0.691,P＜0.01).GA여OGTT중공복혈당(FPG,당부하후0.5、1、2화3h적각점혈당균정정상관(r치위0.511～0.627,균P＜0.01).(3)GA여체질지수정부상관(r=-0.112,P＜0.01).GA여HOMA-β、△I30/△G30정부상관(r치분별위-0.350、-0.263,균P＜0.01).(4)다원축보회귀분석,현시HbAlc、FPG、당부하후3h혈당급△I30/△G30시영향GA적주요인소.결론 신진단2형DM환자GA수평여조기상이도소분비공능밀절상관.
Objective To explore the relationship between glycated albumin (GA) level and pancreatic β cell function in newly diagnosed type 2 diabetics. Methods The subjects sought the confirmation of diabetes diagnosis or underwent diabetes screening tests in high-risk patients from January 2008 to October 2010.All of them underwent 75 g oral glucose tolerance test (OGTT) and insulin releasing test.The levels of GA and hemoglobin Alc(HbAlc) were analyzed by liquid enzymatic method and high performance liquid chromatography respectively. Homeostasis model assessment (HOMA) was used to evaluate the basal insulin resistance (HOMA-IR) and pancreatic β cell function (HOMA-β).△I30/△G30 was used to evaluate early-phase insulin secretion after a glucose load.Results ( 1 ) Among 500 type 2 diabetics according to the diagnostic criteria of WHO ( 1999 ),279 were males and 221 were females.Average age was56.3 ± 12.3,GA (21.1 ±5.4)％ and HbAlc (7.0 ± 1.3)％.(2) A significantly positive relationship was shown between HbAlc and GA ( r =0.691,P ＜ 0.01 ).GA was also positively correlated with fasting plasma glucose ( FPG),0.5 hPG,1 hPG,2 hPG and 3 hPG after a glucose load of OGTT test ( r =0.511 - 0.627,P ＜ 0.01 ).(3) GA was negatively correlated with body mass index ( BMI ) (r =- 0.112,P ＜ 0.01 ),HOMA-β ( r =- 0.350,P ＜ 0.01 ) and △I30/△G30 ( r =- 0.263,P ＜0.01 ).(4) Multivariant stepwise regression analysis showed that HbAlc,FPG,3 hPG and △I30/△G30 were independent factors of GA level Conclusion Glycated albumin level is closely correlated with the function of early-phase insulin secretion in newly diagnosed type 2 diabetics.