摘要
目的探讨血清P选择素(sP-selectin)、胰高血糖素样肽-1(GLP-1)的变化与新诊断2型糖尿病(T2DM)患者胰岛素抵抗的关系。方法选取华中科技大学同济医学院附属武汉中心医院2018年6月~2018年12月初诊断的T2DM患者60例(A组)、具有5年以上糖尿病病程的T2DM患者60例(B组)和健康体检人员60例(C组);检测各组血清sP-selectin、GLP-1、空腹胰岛素(FINS)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)及胰岛素敏感指数(ISI),分析血清sP-selectin、GLP-1与HOMA-IR、ISI的相关性。结果 B组的血清sP-selectin显著高于A组和C组(P <0.05),血清GLP-1显著低于A组和C组(P <0.05);A组的血清sP-selectin显著高于C组(P <0.05),血清GLP-1显著低于C组(P <0.05);A组的HOMA-IR、HbA1c、FINS、FPG均显著高于C组(P <0.05),ISI低于C组(P <0.05);初诊断T2DM患者的血清sPselectin与HOMA-IR呈正相关(P <0.05)、与ISI呈负相关(P <0.05);血清GLP-1与HOMA-IR呈负相关(P <0.05)、与ISI呈正相关(P <0.05)。初诊断T2DM患者的血清sP-selectin、腰围(WC)、病程、BMI升高及GLP-1降低将会增大患者HOMA-IR升高的风险(P <0.05);血清sP-selectin、WC、病程升高及GLP-1降低会增大患者ISI降低的风险。结论血清sP-selectin、GLP-1水平变化参与了初诊断T2DM患者发生胰岛素抵抗的病理过程。
Objective To explore the relationship between the changes of serum P-selectin and glucagon-like peptide-1(GLP-1) and insulin resistance in newly diagnosed type 2 diabetes mellitus(T2 DM). Methods Sixty newly diagnosed patients with type 2 diabetes(group A),60 patients with type 2 diabetes mellitus(group B) and 60 healthy subjects were selected as group C.Serum sP-selectin,GLP-1,fasting insulin(FINS),fasting blood glucose(FPG),insulin resistance index(HOMA-IR),glycosylated hemoglobin(HbA1 c),insulin sensitivity index(ISI) of the three groups were compared. The correlation of serum sP-selectin and GLP-1 with HOMA-IR and ISI was analyzed. Results The serum sP-selectin of group B was significantly higher than that of group A and group C(P < 0.05). The serum GLP-1 of group B was significantly lower than that of group A and group C(P < 0.05). The serum sP-selectin of group A was significant. Compared with group C(P < 0.05),serum GLP-1 in group A was significantly lower than group C(P < 0.05);HOMA-IR,HbA1 c,FINS and FPG in group A were significantly higher than group C(P < 0.05). The ISI of group A was lower than that of group C(P < 0.05). The serum sP-selectin of patients with initial diagnosis of T2 DM was positively correlated with HOMA-IR(P < 0.05) and negatively correlated with ISI(P < 0.05). Serum GLP-1 was negatively correlated with HOMA-IR in patients with T2 DM(P < 0.05) and positively correlated with ISI(P < 0.05). Serum sP-selectin,WC,disease duration,elevated BMI and decreased GLP-1 in patients with initial diagnosis of T2 DM will increase the risk of HOMA-IR in patients(P <0.05). Serum sP-selectin,WC in patients with initial diagnosis of T2 DM Increased disease duration and decreased GLP-1 increased the risk of ISI reduction in patients(P < 0.05). Conclusion Serum levels of sP-selectin and GLP-1 are involved in the pathogenesis of insulin resistance in newly diagnosed patients with T2 DM.
引文
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