目的 分析基线胰岛β细胞功能与短期胰岛素治疗后2型糖尿病疾病缓解的关系.方法 选取2021年1月至2023年12月于浙江省丽水市人民医院建档并行短期胰岛素治疗的2型糖尿病患者150 例,收集基线临床指标、胰岛素抵抗稳态模型(homeostasis model assessment of insulin resistance,HOMA-IR)、胰岛β细胞功能指数(homeostasis model assessment-β,HOMA-β)、胰岛素分泌敏感性指数-2(insulin secretion sensitivity index-2,ISSI-2)以及修正的胰岛 β 细胞功能指数(modified β-cell function index,MBCI),按照停药后观察期内的糖尿病缓解情况分为缓解组(52例)与未缓解组(93例).比较缓解组与未缓解组临床资料,采用多因素二元Logistic回归模型分析基线β细胞功能与短期胰岛素治疗后2型糖尿病疾病缓解的关系.结果 将不符合要求的5例患者剔除后最终纳入研究患者145例.未缓解组年龄中位数50.09岁,缓解组40.83 岁,基线空腹血糖水平(6.4±1.4)mmol/L、HbA1c 水平(6.9±0.8)％比缓解组的(5.3±1.2)mmol/L、(6.1±0.5)％更高,HOMA-β 中位数 37.80、ISSI-2 中位数 149.24 以及 MBCI 中位数 22.94 较缓解组(50.14、278.21、32.80)低,病程较缓解组长,差异有统计学意义(t/Z=-10.301、-4.974、-6.884、27.037、30.702、13.914、-4.803,P＜0.05).多因素分析结果发现,HOMA-β、ISSI-2以及MBCI均为疾病缓解的保护因素(OR=0.903、0.871、0.857,P＜0.05).结论 基线胰岛β细胞功能是短期胰岛素治疗后2型糖尿病疾病缓解的主要病理生理学因素,基线胰岛β细胞功能越好疾病得到缓解的可能性也越大.
Relationship between baseline pancreatic β-cell function and remission of type 2 diabetes after short-term insulin therapy
Objective To investigate the correlation between baseline pancreatic β-cell function and re-mission of type 2 diabetes after short-term insulin therapy.Methods A total of 150 patients with type 2 diabetes who were admitted in Lishui People's Hospital from January 2021 to December 2023 for short-term insulin treat-ment were selected.Baseline clinical indicators,homeostasis model assessment of insulin resistance(HOMA-IR),homeostasis model assessment-β(HOMA-β),insulin secretion sensitivity index-2(ISSI-2),and modified β-cell function index(MBCI)were assessed.According to the remission of diabetes in the observation period after drug withdrawal,they were divided into a remission group(52 cases)and a non-remission group(93 cases).The clinical data of remission group and non-remission group were compared,and the relationship between baseline β-cell function and type 2 diabetes disease remission after short-term insulin treatment was analyzed by multivariate binary Logistic regression model.Results After excluding 5 patients who did not meet the criteria,a cohort of 145 patients was enrolled in the study.The median age of the non-remission group(50.09 years)exceeded that of the remission group(40.83 years).Baseline fasting blood glucose level[(6.4±1.4 mmol/L)]and HbA1c level[(6.9±0.8％)]in the non-remission group were elevated compared to the remission group[(5.3±1.2)mmol/L,(6.1±0.5％)],respectively.Median HOMA-β(37.80),ISSI-2(149.24),and MBCI(22.94)values were lower in the non-remission group compared to the remission group(50.14,278.21,32.80,respectively).The disease duration in the non-remission group was longer than that in the remission group,with statistically significant differences(t/Z=-10.301,-4.974,-6.884,27.037,30.702,13.914,-4.803,respectively,P＜0.05).Multifactorial analysis identified HOMA-β,ISSI-2,and MBCI as protective factors for disease remission(OR=0.903,0.871,0.857,respectively,P＜0.05).Conclusion Baseline pancreatic β-cell function emerges as the predominant pathophysiological determinant for short-term remission of type 2 diabetes mellitus following insulin therapy,with superior baseline pancreatic β-cell function correlating with increased likelihood of disease remission.
万方数据
维普
