CAJ | 학술논문

目的：探讨胰岛素抗体阳性2型糖尿病（T2DM）患者血清胆红素水平变化。方法收集住院T2DM的患者，共726例，按是否应用重组人胰岛素治疗，将糖尿病患者分为胰岛素治疗组和非胰岛素治疗组；将应用重组人胰岛素治疗的T2DM患者按胰岛素抗体阳性或阴性分为胰岛素抗体阳性组与胰岛素抗体阴性组，随机选择84名健康查体者作为正常对照组。分别分析上述各组与正常对照组之间血清胆红素水平的差异。结果血清总胆红素（TBIL）及间接胆红素（IBIL）在胰岛素治疗组、非胰岛素治疗组、正常对照组之间及胰岛素抗体阳性组、胰岛素抗体阴性组、正常对照组之间均有显著性差异（P＜0.05），胰岛素治疗组与非胰岛素治疗组比较二者无显著性差异（P＞0.05），胰岛素抗体阳性组TBIL、IBIL显著低于胰岛素抗体阴性组（P＜0.05）；Logistic回归分析提示低TBIL（OR=0.946，95% CI：0.901～0.994，P=0.028）、低IBIL（OR=0.931，95% CI：0.876～0.988，P=0.019）是胰岛素抗体阳性的危险因素；与无胰岛素抵抗患者比较，胰岛素抵抗患者血清TBIL、DBIL、IBIL均明显降低（均P＜0.01）；胰岛素抵抗患者INS-Ab阳性率显著高于无胰岛素抵抗患者（P=0.000）。结论胰岛素抗体阳性T2DM患者血清TBIL、IBIL水平较低；T2DM患者低血清TBIL、IBIL水平是胰岛素抗体阳性及胰岛素抵抗的危险因素。
목적：탐토이도소항체양성2형당뇨병（T2DM）환자혈청담홍소수평변화。방법수집주원T2DM적환자，공726례，안시부응용중조인이도소치료，장당뇨병환자분위이도소치료조화비이도소치료조；장응용중조인이도소치료적T2DM환자안이도소항체양성혹음성분위이도소항체양성조여이도소항체음성조，수궤선택84명건강사체자작위정상대조조。분별분석상술각조여정상대조조지간혈청담홍소수평적차이。결과혈청총담홍소（TBIL）급간접담홍소（IBIL）재이도소치료조、비이도소치료조、정상대조조지간급이도소항체양성조、이도소항체음성조、정상대조조지간균유현저성차이（P＜0.05），이도소치료조여비이도소치료조비교이자무현저성차이（P＞0.05），이도소항체양성조TBIL、IBIL현저저우이도소항체음성조（P＜0.05）；Logistic회귀분석제시저TBIL（OR=0.946，95% CI：0.901～0.994，P=0.028）、저IBIL（OR=0.931，95% CI：0.876～0.988，P=0.019）시이도소항체양성적위험인소；여무이도소저항환자비교，이도소저항환자혈청TBIL、DBIL、IBIL균명현강저（균P＜0.01）；이도소저항환자INS-Ab양성솔현저고우무이도소저항환자（P=0.000）。결론이도소항체양성T2DM환자혈청TBIL、IBIL수평교저；T2DM환자저혈청TBIL、IBIL수평시이도소항체양성급이도소저항적위험인소。
Objective To study the relationship between insulin antibody (INS-Ab) and the changes of serum bilirubin levels in patients with type 2 diabetes mellitus.Methods726 cases of hospitalized patients with type 2 diabetes mellitus (T2DM) were divided into insulin-treated group and non-insulin-treated group, and patients treated with recombinant human insulin were divided into two groups, INS-Ab positive group and INS-Ab negative group. At the same time, 84 healthy subjects in examination centers were randomly selected as controls. Then, the differences of serum bilirubin levels between these groups and the control group were analysed.ResultsThe differences of TBIL and IBIL levels between insulin-treated group, non-insulin-treated group, the control group and that between INS-Ab positive group, INS-Ab positive group, the control group were significant (P<0.05). There were no significant differences of TBIL and IBIL between insulin-treated group and non-insulin-treated group (P>0.05), while, TBIL and IBIL levels of INS-Ab positive group were significantly lower than that of INS-Ab negative group (P<0.05); Logistic regression analysis showed that decreased TBIL (OR=0.946, 95%CI: 0.901-0.994,P=0.028) and decreased IBIL (OR=0.931, 95%CI: 0.876-0.988,P=0.019) are the risk factors of INS-Ab. TBIL, DBIL and IBIL of patients with insulin resistance were significantly lower than that of patients without insulin resistance (P<0.01). The INS-Ab positive rate of them was higher than that of patients without insulin resistance, and the difference was significant (P=0.000). ConclusionComparing with patients in INS-Ab negative group and the control group, the serum TBIL and IBIL levels are lowest in INS-Ab positive patients with T2DM. Decreased TBIL and decreased IBIL are the risk factors of INS-Ab and insulin resistance in patients with T2DM.