长病程2型糖尿病患者胰岛β细胞功能与BMI的相关性研究

doi:10.20223/j.cnki.1000-8535.2025.08.012

摘要/Abstract

摘要： 目的探讨长病程2型糖尿病（T2DM）患者体质指数（BMI）与胰岛β细胞功能间的相关关系。方法选取2023年12月—2024年3月于承德市中心医院内分泌风湿免疫科住院的260例长病程（病程≥10年）T2DM患者作为研究对象,依据BMI将其分成正常组、超重组和肥胖组,比较三组间一般资料、检验学指标及检查的差异,分析胰岛β细胞功能与各指标间的相关性。结果三组研究对象在空腹静脉血糖（FPG）、空腹C肽（FCP）、胰岛素抵抗指数（HOMA-IR）、尿酸（UA）、甘油三酯（TG）等上差异有统计学意义（P<0.05）,在胰岛β细胞功能指数（HOMA-β）比较差异无统计学意义（P>0.05）;肥胖组的FPG、FCP、HOMA-IR、UA、TG均高于正常组（P<0.05）,超重组的UA、TG均高于正常组（P<0.05）,肥胖组的FPG、HOMA-IR、UA高于超重组（P<0.05）,Spearman相关分析结果显示HOMA-β与体质量指数（BMI）无相关性（r=0.046,P=0.461）,HOMA-β与UA（r=0.226,P<0.001）、TG（r=0.148,P=0.017）呈正相关,HOMA-IR与BMI（r=0.279,P<0.001）与、UA相关（r=0.284,P<0.001）及TG（r=0.349,P<0.001）呈正相关,多元线性回归分析显示UA是HOMA-β的影响因素（P<0.05）,BMI、UA、TG是HOMA-IR的影响因素（P<0.05）。结论长病程的T2DM患者,其胰岛素抵抗水平随着BMI的增加逐渐升高,而胰岛β细胞功能指数与BMI的相关性不显著。同时,UA和TG也是长病程T2DM患者胰岛β细胞功能的影响因素。

关键词: 2型糖尿病, 体质指数, 胰岛β细胞功能指数;, 胰岛素抵抗指数

Abstract: Objective To explore the correlation between body mass index（BMI）and islet β cell function in patients with long course type 2 diabetes mellitus（T2DM）．Methods A total of 260 patients with T2DM with a long course of disease（course≥10 years）admitted to the Department of Endocrinology and Rheumatology of Chengde Central Hospital from December 2023 to March 2024 were selected as the study objects,and were divided into normal group,overweight group and obese group according to BMI．Comparison among the three groups in general data,inspection index and and the difference of the islet β cell function were performed,and the correlation among the indexes was analyzed．Results There were statistically significant differences in fasting plasma glucose（FPG）,fasting C peptide（FCP）,homeostasis model assessment-insulin resistance（HOMA-IR）,uric acid（UA）and triglycerides（TG）among the three groups（P<0.05）,but no statistically significant differences in homeostatic model assessment of β-cell function（HOMA-β）（P>0.05）．The levels of FPG,FCP,HOMA-IR,UA and TG in the obese group were higher than those in the normal group（P<0.05）;the levels of UA and TG in the overweight group were higher than those in the normal group（P<0.05）;the levels of FPG,HOMA-IR and UA in the obese group were higher than those in the overweight group（P<0.05）．Spearman correlation analysis showed that HOMA-β was not correlated with BMI（r=0.046,P=0.461）,but was positively correlated with UA and TG（r=0.226,P<0.001;r=0.148,P=0.017）,HOMA-IR was positively correlated with BMI,UA and TG（r=0.279,P<0.001;r=0.284,P<0.001;r=0.349,P<0.001）．Multiple linear regression analysis showed that UA was the influencing factor of HOMA-β（P<0.05）,BMI,UA and TG were the influencing factors of HOMA-IR（P<0.05）． Conclusions In T2DM patients with long disease course,the level of insulin resistance increased gradually with the increase of BMI,but the correlation between β-cell function index and BMI was not significant．At the same time,UA and TG are also factors affecting the function of islet β cells in patients with long-course T2DM．

Key words: type 2 diabetes mellitus, body mass index, islet β cell function index;, insulin resistance index

吴香珍, 赵君, 陈曼玉, 郝凤杰. 长病程2型糖尿病患者胰岛β细胞功能与BMI的相关性研究[J]. 广州医药, 2025, 56(8): 1094-1102.

WU Xiangzhen, ZHAO Jun, CHEN Manyu, HAO Fengjie. Correlation between islet β cell function and BMI in patients with long course type 2 diabetes[J]. Guangzhou Medical Journal, 2025, 56(8): 1094-1102.

参考文献

[1] SUN H,SAEEDI P,KARURANGA S,et al.IDF Diabetes Atlas:Global,regional and country-level diabetes prevalence estimates for2021 and projections for 2045[J].Diabetes Res Clin Pract,2022(183):109119.
[2] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华内分泌代谢杂志,2021,37(4):311-398.
[3] 蔡宸威,何颖.肥胖者胰岛β细胞功能和质量的研究进展[J].中国处方药,2023,21(5):181-184.
[4] YOON K H,LEE J H,KIM J W,et al.Epidemic obesity and type 2 diabetes in Asia[J].Lancet,2006,368(9548):1681-1688.
[5] 陈春明,孔灵芝主编.中华人民共和国卫生部疾病控制司编著.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006.
[6] 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β细胞功能[J].中南大学学报(医学版),2004,29(4):419-423.
[7] 王琛. 2型糖尿病患者胰岛功能随病程衰竭速度及影响因素的研究[D].青岛:青岛大学,2017.
[8] TALCHAI C,XUAN S,LIN H V,et al.Pancreatic β cell dedifferentiation as a mechanism of diabetic β cell failure[J].Cell,2012,150(6):1223-1234.
[9] 劳美铃,魏爱生,格桑旺姆,等.肥胖2型糖尿病患者血脂、HbA1C水平与胰岛素抵抗的相关性分析[J].公共卫生与预防医学,2024,35(1):136-140.
[10] 莫帅帅,孙立娟.超重/肥胖2型糖尿病患者腹部脂肪分布与胰岛素抵抗的相关性[J].中国实验诊断学,2020,24(1):57-59.
[11] CZECH M P.Insulin action and resistance in obesity and type 2 diabetes[J].Nat Med,2017,23(7):804-814.
[12] GLUVIC Z,ZARIC B,RESANOVIC I,et al.Link between metabolic syndrome and insulin resistance[J].Curr Vasc Pharmacol,2017,15(1):30-39.
[13] KALANTARHORMOZI M,JOUYAN N,ASADIPOOYA K,et al.Evaluation of adipokines,adiponectin,visfatin,and omentin,in uncomplicated type I diabetes patients before and after treatment of diabetic ketoacidosis[J].J Endocrinol Invest,2020,43(12):1723-1727.
[14] 胡叶子. 2型糖尿病患者体成分改变与胰岛功能相关性研究[D].南京:东南大学,2020.
[15] AHMADIEH H,AZAR S.Effects of sodium glucose cotransporter-2 inhibitors on serum uric acid in type 2 diabetes mellitus[J].Diabetes Technol Ther,2017,19(9):507-512.
[16] 李尚建,罗秀梅,陆志强,等.2型糖尿病患者血尿酸水平与胰岛β细胞功能的相关性[J].中国临床医学,2023,30(2):251-256.
[17] 毕娅琼,付梦菲,张欢,等.C肽及胰岛自身抗体在糖尿病分型诊断中的价值研究[J].华中科技大学学报(医学版),2023,52(3):376-381.
[18] 霍劲芳. 不同病程2型糖尿病患者胰岛素抵抗和胰岛β细胞功能的比较[D].南宁:广西医科大学,2014.