摘要
目的 探究老年湿热证体检人群糖尿病前期和早期的影响因素及糖代谢指标与其他代谢紊乱的客观指标的相关性.方法 将纳入的325名研究对象分为对照组、糖尿病前期组和糖尿病早期组.记录研究对象的体质量、体质量指数(BMI)、腰围(WC)等一般临床资料并检测心率、空腹血糖(FBG)、餐后2 h血糖(2 hPG)、空腹胰岛素(FINS)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、丙氨酸氨基转移酶(ALT)、血清尿酸(UA)、尿微量白蛋白/尿肌酐(UACR)等实验室检查指标的水平,统计分析糖代谢指标与各客观指标的相关性.结果 Pearson和Spearman相关性分析的结果表明,WC、BMI、ALT、TG、HDL-C等客观指标与三组的HOMA指数的相关性有统计学意义(P<0.05).在老年湿热证人群中,多元线性回归显示,糖尿病前期状态下,BMI对胰岛素抵抗水平(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)的影响最强;糖尿病早期时,BMI对HOMA-IR和胰岛素敏感性指数(HOMA-IS)的影响也很大,且心率、UACR、TG和HDL-C等与心血管、血脂和肝、肾功能相关的指标也与HOMA-β有统计学意义(P<0.05)的相关性.典型相关分析显示,糖尿病前期与肥胖指标关系最密切的是BMI,与血脂指标密切程度最高的是TG.发展到糖尿病早期,与肥胖、血脂和肝、肾功能指标关系最密切的分别为WC、HDL-C和UA.结论 T2DM前期和早期老年湿热证人群的HOMA指数等糖代谢指标与BMI、TG、HDL-C、UACR等客观指标存在一定的相关性.
Abstract
Objective To investigate the influencing factors of impaired glucose regulation and early stage of diabetes and the correlation between glycemic metabolic indicators and objective indicators of other metabolic disorders in an elderly physical ex-amination population with damp heat syndrome. Methods The included 325 study subjects were divided into control,impaired glucose regulation and early diabetes groups. General clinical data including weight,body mass index (BMI),waist circumfer-ence (WC)were recorded and the levels of laboratory tests including heart rate,fasting blood glucose (FBG),postprandial 2 h blood glucose (2 hPG),fasting insulin (FINS),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),alanine aminotransferase (ALT),serum uric acid (UA),urinary microalbumin/urinary creatinine (UACR)were measured. The corre-lation between glycemic metabolic indicators and various objective indicators was statistically analyzed. Results The results of Pearson and Spearman correlation analysis showed that the correlation between objective indicators such as waist circumference,BMI,ALT,TG,and HDL-C and the HOMA index of the three groups was statistically significant (P<0. 05). In the elderly damp heat syndrome population,multiple linear regression showed that BMI had the strongest effect on homeostasis model assess-ment for insulin resistance (HOMA-IR)and homeostasis model assessment for islet β-cell function (HOMA-β)in impaired glu-cose regulation. It also showed that BMI also had a strong effect on the HOMA-IR and homeostasis model assessment for insulin sensitivity (HOMA-IS)in early stage of diabetes,and that heart rate,UACR,TG,and HDL-C,which were related to cardio-vascular,lipid,liver and kidney functions,also had statistically significant (P<0. 05)correlations with HOMA-β. Canonical correlation analysis showed that in impaired glucose regulation,the closest relationship with obesity indicators was BMI,and the highest degree of closeness with lipid indicators was TG;in early stage of diabetes,the closest relationships with obesity,lipids,and indicators of liver and kidney function were waist circumference,HDL-C,and UA,respectively. Conclusion Glycemic metabolic indicators such as HOMA index were correlated with objective indicators such as BMI,TG,HDL-C,and UACR in the elderly damp heat syndrome population in impaired glucose regulation and early stage of diabetes.
基金项目
苏州市姑苏卫生人才计划培养项目(GSWS2020079)
苏州市科技局民生科技示范项目(SS202006)
苏州市科技发展计划(基础研究-医学应用基础研究)指导性项目(SKYD2023041)
南京中医药大学自然科学基金重点项目(XZR2023021)
维普
万方数据