2型糖尿病患者胰岛素强化治疗后空腹C肽与铁蛋白变化的关系
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摘要
目的探讨短期胰岛素泵强化治疗的2型糖尿病(type 2 diabetes mellitus,T2DM)患者空腹C肽(fasting C-peptide,FC-P)与血清铁蛋白(serum ferritin,SF)变化的相关性。了解胰岛素强化治疗后胰岛β细胞功能变化的影响因素,为临床评估患者胰岛β细胞功能寻找简便易行的方法。方法对305例T2DM患者行1周左右胰岛素泵治疗。记录血糖达标前、后SF,空腹血糖(fasting plasma glucose,FPG)及FC-P。结果胰岛素强化治疗后FC-P升高,FPG下降,SF随之改变。多因素线性逐步回归分析:ΔSF(血清铁蛋白变化量)、BMI(体重指数)、HbA1C(糖化血红蛋白)、病程是胰岛素强化治疗后FC-P的独立影响因素。FC-P与ΔSF呈负相关(r=0.651 t=-3.328,P<0.01)。结论 T2DM患者经短期胰岛素泵强化治疗后胰岛β细胞功能越好者,SF下降幅度越大。
Objective To investigate the correlation between fasting C-peptide(FC-P) and serum ferritin(SF) in type 2 diabetic patients(T2DM) treated by short-term continuous subcutaneous insulin infusion(CSII).To understand the influencing factors of islet beta cell function changes after intensive insulin therapy.To find a simple and easy method for clinical evaluation of isletβcell function.Methods A total of three hundred and five patients with T2DM in endocrinology department were enrolled in this study.All the subjects were treated with CSII about 1 week.SF,fasting plasma glucose(FPG),and FC-P were recorded before and after the blood sugar reached the standard.Results FC-P increased,FPG decreased and SF changed after intensive insulin therapy.Multivariate linear stepwise regression analysis showed that SF,BMI(body mass index),HbA1 C(glycosylated hemoglobin) and course of disease were independent influencing factors of FC-P after intensive insulin therapy.FC-P was negatively correlated with SF(r=0.651,t=3.328,P<0.01).Conclusion The better the function of isletβcells in patients with type 2 diabetes mellitus after short-term intensive insulin pump treatment,the greater the decrease of SF.
Objective To investigate the correlation between fasting C-peptide(FC-P) and serum ferritin(SF) in type 2 diabetic patients(T2DM) treated by short-term continuous subcutaneous insulin infusion(CSII).To understand the influencing factors of islet beta cell function changes after intensive insulin therapy.To find a simple and easy method for clinical evaluation of isletβcell function.Methods A total of three hundred and five patients with T2DM in endocrinology department were enrolled in this study.All the subjects were treated with CSII about 1 week.SF,fasting plasma glucose(FPG),and FC-P were recorded before and after the blood sugar reached the standard.Results FC-P increased,FPG decreased and SF changed after intensive insulin therapy.Multivariate linear stepwise regression analysis showed that SF,BMI(body mass index),HbA1 C(glycosylated hemoglobin) and course of disease were independent influencing factors of FC-P after intensive insulin therapy.FC-P was negatively correlated with SF(r=0.651,t=3.328,P<0.01).Conclusion The better the function of isletβcells in patients with type 2 diabetes mellitus after short-term intensive insulin pump treatment,the greater the decrease of SF.
引文
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[11] 张放,纪立农.铁代谢异常对糖代谢和糖化血红蛋白的影响[J].中国糖尿病杂志,2017,25(8):765-767
[12] 王培娜,张鸾文,常彦忠.人体的铁需求[J].生物学通报,2015,50(12):6-7
[13] Krisai P,Leib S,Aeschbacher S,et al.Relationships of iron metabolism with insulin resistance and glucose levels in young and healthy adults[J].Eur J Intern Med,2016,32:31-37
[14] 李霞,周智广,亓海英,等.用空腹C肽代替胰岛素改良Homa公式评价胰岛素抵抗和胰岛素β细胞功能[J].中南大学学报(医学版),2004,29(4):419-423
[15] 王钰,余江毅,唐红.血清铁蛋白与2型糖尿病相关性的研究进展[J].医学综述,2012,18(5):741-743
[2] 魏剑芬,王颖,吴乃君,等.2型糖尿病肥胖患者血清铁蛋白与胰岛素抵抗关系的研究[J].中国糖尿病杂志,2015,23(7):595-597
[3] 李志国,王琦.酒精性肝病患者血清铁蛋白和血清铁检测的意义[J].实用肝脏病杂志,2012,15(3):254-255
[4] 张家庆.Homa2-IR是个较好的胰岛素抵抗指数[J].中华内分泌代谢杂志,2005,21(4):304-305
[5] 王小钦,林果为.重新认识网织红细胞参数的临床价值[J].中华血液学杂志,2014,35(1):1-3
[6] Hansen JB,moen IW,Mandrup-poulsen T.Iron:the hard player in diabetes pathophysilogy[J].Acta Physiol (Oxf),2014,210(4):717-732
[7] 陈敏,冯婷,杨波,等.铁超负荷对大鼠胰岛β细胞功能的影响[J].生物医学工程学杂志,2009,26(5):1088-1092
[8] MacDonald MJ,Cook JD,Epstein ML,et al.Large amount of (apo) ferritin in the pancreatic insulin cell and its stimulation by glucose[J].FASEB J,1994,8(10):777-781
[9] 张克良,刘大成,孟小望,等.2型糖尿病患者强化治疗前后血清铁变化与胰岛素抵抗的关系[J].中国糖尿病杂志,2017,25(5):411-414
[10] 杨坤,廖有乔,李秀楼,等.新诊断2型糖尿病患者高血糖状态纠正前后血清铁蛋白的变化[J].中国糖尿病杂志,2012,20(3):212-215
[11] 张放,纪立农.铁代谢异常对糖代谢和糖化血红蛋白的影响[J].中国糖尿病杂志,2017,25(8):765-767
[12] 王培娜,张鸾文,常彦忠.人体的铁需求[J].生物学通报,2015,50(12):6-7
[13] Krisai P,Leib S,Aeschbacher S,et al.Relationships of iron metabolism with insulin resistance and glucose levels in young and healthy adults[J].Eur J Intern Med,2016,32:31-37
[14] 李霞,周智广,亓海英,等.用空腹C肽代替胰岛素改良Homa公式评价胰岛素抵抗和胰岛素β细胞功能[J].中南大学学报(医学版),2004,29(4):419-423
[15] 王钰,余江毅,唐红.血清铁蛋白与2型糖尿病相关性的研究进展[J].医学综述,2012,18(5):741-743