摘要
目的 探讨不同体重指数(BMI)分级的初诊2型糖尿病(T2DM)患者胰岛素抵抗(HOMA-IR)水平与糖化白蛋白(GA)、糖化血红蛋白(HbA1c)、GA/HbA1c的关系.方法 选取120例初诊T2DM患者,根据BMI将其分为正常组(BMI＜24 kg·m-2,n=40)、超重组(24 kg·m-2≤BMI≤28 kg·m-2,n=40)、肥胖组(BMI＞28 kg·m-2,n=40).比较 3 组一般生化指标、GA、HbA1c、GA/HbA1c、HOMA-IR 水平;BMI 分级与 GA、HbA1c、GA/HbA1c、HOMA-IR的关系,3组HOMA-IR与GA、HbA1c、GA/HbA1c的关系均采用Spearman秩相关分析.结果 3组空腹胰岛素(Fins)、HOMA-IR、HbA1c、GA、GA/HbA1c水平比较差异有统计学意义(P＜0.05);正常组Fins、HOMA-IR高于肥胖组(P＜0.05);HbA1c水平比较:超重组与肥胖组差异无统计学意义(P＞0.05),超重组与肥胖组均高于正常组(P＜0.05).BMI 分级与 GA、GA/HbA1c 呈负相关(r=-0.482、r=-0.828,P＜0.05),与 HbA1c 呈正相关(r=0.293,P＜0.05).正常组 HOMA-IR 与 GA、HbA1c 呈正相关(r=0.407、r=0.546,P＜0.05),与 GA/HbA1c呈负相关(r=-0.405,P＜0.05);超重组 HOMA-IR 与 GA、HbA1c 呈正相关(r=0.374、r=0.826,P＜0.05),与GA/HbA1c呈负相关(r=-0.630,P＜0.05);肥胖组 HOMA-IR 与 HbA1c 呈正相关(r=0.596,P＜0.05),与GA/HbA1c呈负相关(r=-0.847,P＜0.05),但与GA无显著相关性(P＞0.05).结论 初诊T2DM患者可以采用GA、GA/HbA1c评估患者血糖情况,且诊疗过程中应考虑BMI对血糖的影响,尤其是肥胖体质患者.
Abstract
Objective To investigate the correlation between insulin resistance(HOMA-IR)level,glycated albumin(GA),glycated hemoglobin(HbA1c)and GA/HbA1c with different body mass index(BMI)grades in newly diagnosed T2DM patients.Methods A total of 120 patients with newly diagnosed T2DM were selected and categorized into the normal group(BMI＜24 kg·m-2,n=40),the overweight group(24 kg·m-2 ≤BMI≤ 28 kg·m-2,n=40),and the obese group(BMI＞28 kg·m-2,n=40)based on BMI.General biochemical indexes,GA,HbA1c,GA/HbA1c,and HOMA-IR levels were compared among the 3 groups;the relationship between BMI classification and GA,HbA1c,GA/HbA1c,and HOMA-IR,and the relationship between HOMA-IR and GA,HbA1c,and GA/HbA1c among the 3 groups were analyzed by Spearman rank correlation.Results The differences in fasting insulin(Fins),HOMA-IR,HbA1c,GA,and GA/HbA1c levels among the 3 groups were statistically significant(P＜0.05);Fins and HOMA-IR were higher in the normal group than those in the obese group(P＜0.05);the HbA1c levels were not statistical-ly different between the overweight group and the obese group(P＞0.05),and the HbA1c levels in both the overweight group and the obese group were higher than those in the normal group(P＜0.05).BMI classification was negatively correlated with GA and GA/HbA1c(r=-0.482,r=-0.828,P＜0.05)and positively correlated with HbA1c(r=0.293,P＜0.05).In the normal group,HOMA-IR was positively correlated with GA and HbA1c(r=0.407,r=0.546,P＜0.05)and negative1y correlated with GA/HbA1c(r-0.405,P＜0.05);in the overweight group,HOMA-IR was positively correlated with GA and HbA1c(r=0.374,r=0.826,P＜0.05)and negatively correlated with GA/HbA1c(r=-0.630,P＜0.05);in the obese group,HOMA-IR was positively correlated with HbA1c(r=0.596,P＜0.05)and negatively correlated with GA/HbA1c(r=-0.847,P＜0.05),but not significantly correlated with GA(P＞0.05).Conclusion GA and GA/HbA1c can be used to assess blood glucose in newly diagnosed T2DM patients,and the influence of BMI on blood glucose should be considered during diagnosis and treatment,especially in obese patients.
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