首页|初诊T2DM患者BMI与GA、GA/HbA1c、HOMA-IR的关系

初诊T2DM患者BMI与GA、GA/HbA1c、HOMA-IR的关系

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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.
The Correlation of HOMA-IR Level,GA,HbA1c and GA/HbA1c with BMI Grades in Newly Diagnosed T2DM
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.

newly diagnosed type 2 diabetes mellitusglycosylated albuminglycosylated albumin/glycosylated hemoglobininsulin resistancebody mass index

陈琳、张扬麟、钟荣玉、刘梦婷、邓垚

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南昌市第三医院老年医学科,南昌 330009

南昌市第三医院检验科,南昌 330009

南昌市第三医院内分泌科,南昌 330009

初诊2型糖尿病 糖化白蛋白 糖化白蛋白/糖化血红蛋白 胰岛素抵抗 体重指数

江西省卫健委科技计划项目

202311268

2024

10.13764/j.cnki.lcsy.2024.03.002

实用临床医学
南昌大学

实用临床医学

影响因子：0.818
ISSN：1009-8194
年,卷(期)：2024.25(3)
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