目的 探讨远程药学管理模式联合延续护理在2型糖尿病（T2DM）合并冠状动脉病变患者居家用药中的应用效果。方法 选取2021年6月—2023年6月在广州医科大学附属第三医院诊治的200例T2DM合并冠状动脉病变患者为研究对象,根据干预方式不同分为常规组100例和研究组100例。常规组患者给予院内院外常规护理,研究组在常规组的基础上给予远程药学管理模式联合延续护理。评估患者用药依从性、饮食依从性、运动依从性、自我管理能力、生活质量[36条目简明健康量表（SF-36）]及心血管事件发生情况。结果 研究组用药、饮食、运动依从性均高于常规组（P<0.05）。相较于干预前,两组患者在干预后的自我管理机能、自我责任感、自我概念及健康知识分值均升高,且研究组高于常规组（P<0.05）。相较于干预前,两组患者在干预后的活力（VT）、精神健康（MH）、情感职能（RE）、躯体疼痛（BP）、生理功能（PF）、社会功能（SF）、生理职能（RP）、总体健康（GH）分值均升高,且研究组高于常规组（P<0.05）。研究组与常规组患者心血管不良事件发生率分别为2例（2.00%）、15例（15.09%）,研究组高于常规组（χ²=10.865,P<0.05）。结论 远程药学管理模式联合延续护理能够提高T2DM合并冠状动脉病变患者的用药管理依从性,提高患者自我管理能力,改善生活质量,降低不良心血管事件的发生率。

Objective To explore the application effect of remote pharmacy management mode combined with continuous nursing in the home medication of type 2 diabetes mellitus（T2DM）patients with coronary artery disease．Methods A total of 200 patients with T2DM complicated with coronary artery diseases who were diagnosed and treated in the Third Affiliated Hospital of Guangzhou Medical University from June 2021 to June 2023 were selected as the study subjects．They were divided into a conventional group of 100 patients and a study group of 100 patients based on different intervention methods．The patients in the conventional group received routine care both in and out of the hospital,while the study group received remote pharmaceutical management mode combined with continuous care on the basis of the conventional group．Patient medication compliance,dietary compliance,exercise compliance,self-management ability,quality of life[36 item concise health scale（SF-36）] and incidence of adverse cardiovascular events were assessed．Results The compliance of medication,diet and exercise in the study group were significantly higher than those in the conventional group（P<0.05）．Compared to before intervention,the self-management function,sense of responsibility,self-concept and health knowledge scores of both groups of patients were significantly increased after intervention,and the scores of the study group were significantly higher than those in the conventional group（P<0.05）．Compared to before intervention,the Vitality（VT）,Mental Health（MH）,Emotional Function（RE）,Physical Pain（BP）,Physiological Function（PF）,Social Function（SF）,Physiological Function（RP）and Overall Health（GH）scores of both groups of patients were significantly increased after intervention,and the scores of the study group was significantly higher than those of the conventional group（P<0.05）．The incidence of cardiovascular adverse events in the study group and the conventional group were 2 cases（2.00%）and 15 cases（15.09%）,respectively,with the study group significantly higher than the conventional group（χ²=10.865,P<0.05）．Conclusions The combination of remote pharmaceutical management mode and continuous care can significantly improve the medication management compliance of T2DM patients with coronary artery disease,improve their self-management ability,improve the quality of their life and reduce the incidence of adverse cardiovascular events．

目的 观察2型糖尿病大鼠肝脏组织中circRNA-0003340的表达,并探讨与糖尿病的关系。方法 选取健康雄性SD大鼠30只,随机分为2组,正常对照组（NC组,n=10）与2型糖尿病组（T2DM组,n=20）,检测FPG、FINs、HbA1c、TC、TG、HDL-C、LDL-C、AST、ALT;行腹腔注射糖耐量实验和胰岛素耐量实验,计算胰岛素抵抗指数（HOMA-IR）;HE染色观察胰岛细胞形态;RT-PCR检测大鼠肝脏组织circRNA-000334的表达量。结果 与NC组比较,T2DM组的AST、ALT、FPG、HAb1c、FINs、HOMA-IR、TG、TC、LDL-C均升高（P<0.05）,HDL-C降低（P<0.05）。circRNA-0003340在T2DM组肝脏组织中的表达较NC组肝脏组织中的表达是下调的,差异有统计学意义（P<0.05）。Sperman相关分析示大鼠肝脏组织中circRNA-0003340表达水平与FPG、TG及TC呈负相关（P<0.05）。结论 circRNA-003340的表达水平可能与T2DM大鼠的糖脂代谢密切相关,circRNA-003340在肝脏组织中的表达水平下调可能参与T2DM的发生发展。

Objective To observe the expression of circRNA-0003340 in the liver tissue of type 2 diabetes mellitus （T2DM）rats and to explore its relationship with diabetes．Methods A total of 30 healthy male SD rats were randomly divided into two groups,normal control group（NC group,n=10）and T2DM group（n=20）,and fasting plasma glucose（FPG）,fasting insulins（FINS）,glycated hemoglobin（HbA1c）,total cholesterol（TC）,triglyceride (TG）,high-density lipoprotein cholesterol（HDL-C）,low-density lipoprotein cholesterol（LDL-C）,aspartate aminotransferase（AST）,alanine aminotransferase（ALT）levels were detected．Intraperitoneal glucose tolerance test and insulin tolerance test were performed to calculate the insulin resistance index（HOMA-IR）,HE staining was used to observe islet cell morphology,the expression of circRNA-000334 in rat liver tissue was detected by RT-PCR．Results Compared with the NC group,the T2DM group had increased AST,ALT,FPG,HAb1c,FINs,HOMA-IR,TG,TC,LDL-C（P<0.05）and decreased HDL-C（P<0.05）．The expression of circRNA-0003340 in liver tissue in T2DM group was down-regulated compared with that in NC group,with statistically significant difference（P<0.05）．Sperman correlation analysis showed that the expression level of circ-0003340 in rat liver tissue was negatively correlated with FPG,TG and TC（P<0.05）．Conclusions The expression level of circRNA-003340 may be closely related to the glycolipid metabolism of T2DM rats,and the downward regulation of the circRNA-003340 expression level in liver tissues may be involved in the occurrence and development of T2DM．

目的 分析近年来2型糖尿病自我管理水平的研究进展,讨论其自我管理水平的影响因素及给出相应的建议。方法 通过中国知网、万方医学、迈特思创外文期刊等检索工具,搜索“2型糖尿病”“自我管理”等关键词,收集2000年—2022年相关文献资料,采用文献研究方法进行分析。结果 共检索相关文献1 053条,通过阅读文献以及文献引文,共筛选出重要文献35篇。结论 归纳总结介绍了近年来有关2型糖尿病自我管理水平的研究进展、自我管理的各个方面,包括概念、评估工具、影响因素、与糖尿病并发症的关系及提升方法等,最后文章的总结部分提出了未来研究的方向和挑战。

Objective To analyze the research progress on self-management levels of type II diabetes in recent years,discuss the influencing factors of self-management levels,and provide corresponding suggestions．Methods This article collected relevant literature from 2000 to 2022 by searching tools such as CNKI,Wanfang Medical and Medline for keywords such as “type II diabetes”and“self-management”,and analyzed the literature using a literature research method．Results A total of 1,053 relevant literature were retrieved,and 35 important literature were selected through reading literature main body and citation．Conclusions This article summarizes the research progress on self-management levels of type II diabetes in recent years,including various aspects of self-management such as concepts,evaluation tools,influencing factors,the relationship with diabetic complications,and improvement methods．The conclusion part of the article proposes directions and challenges for future research．

目的 探讨2型糖尿病（T2DM）患者慢性肾脏病（CKD）发生的危险因素以及其与肥胖之间的相关性。方法 选择2019年3月—2021年12月我院收治的552例T2DM患者作为研究对象,根据是否发生CKD进行分组,其中合并CKD患者136例、未合并CKD患者416例,对2组患者的一般资料及实验室指标进行单因素回归分析比较;对于未合并CKD的T2DM患者进行为期1年的随访,统计T2DM患者CKD的发生率,并针对随访群体的一般资料及实验室指标进行对比分析,通过单因素Logistic回归分析患者发生CKD的影响因素,了解T2DM患者CKD的发生与肥胖之间的关系。结果 合并CKD和未合并CKD的T2DM患者间的年龄、病程、肝功能指标、血脂指标中的低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、肾功能指标中的尿酸、肾小球滤过率（eGFR）比较差异均无统计学意义（均P>0.05）,组间在性别构成、BMI、血压、白蛋白、血红蛋白、血脂指标中的总胆固醇（TC）及甘油三酯（TG）、血糖及肾功能指标中尿白蛋白/肌酐比（UACR）比较差异均有统计学意义（均P<0.05）。396例未合并CKD的T2DM患者随访结果显示,随访期间发生CKD患者123例、未发生CKD患者293例,组间的性别构成、BMI、舒张压、血红蛋白、丙氨酸氨基转移酶、白蛋白、总胆红素、TC、LDL-C、HDL-C、尿酸、糖化血红蛋白及eGFR比较差异均无统计学意义（均P>0.05）,而组间年龄、病程、收缩压、天冬氨酸氨基转移酶、TG、空腹血糖（FPG）及UACR比较差异均有统计学意义（均P<0.05）。单因素Logistic回归分析结果显示,T2DM患者发生CDK的独立危险因素包括肥胖和收缩压、TG及FPG等指标升高（P<0.05）。T2DM患者的BMI与CKD的发生有关,当患者的BMI在28~31 kg/m²之间时,其CKD的发生率明显增加。结论 T2DM患者的CKD发生与肥胖因素有一定相关性,危险因素包括肥胖、血脂血压血糖异常等,T2DM患者的BMI在28~31 kg/m²之间时,其发生CKD的风险会有所增加,故需要对患者的BMI进行有效控制,降低CKD发生率,以避免病情恶化。

目的 探讨绝经后2型糖尿病人群性激素水平与体质指数（BMI）的关系。方法 收集2022年1月—2023年1月在我院住院的2型糖尿病患者,随机选取自然绝经后女性184例,根据其BMI分组,其中肥胖组23例、超重组74例、BMI正常组87例,比较3组间临床资料及性激素差异。结果 3组间腰围、空腹血糖（FPG）、甘油三酯、高密度脂蛋白胆固醇、血尿酸、卵泡刺激素（FSH）、黄体生成素（LH）、雌激素（E₂）比较差异均有统计学意义（均P<0.05）,肥胖组和超重组的E₂高于正常组,FSH及LH低于正常组。3组间年龄、糖化血红蛋白、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、催乳素、睾酮、孕酮比较差异均无统计学意义（均P>0.05）。Logistic回归分析显示,过高的腰围和较低的FSH、LH是绝经后2型糖尿病女性肥胖的影响因素。结论 2型糖尿病绝经后女性应控制腹型肥胖,定期复查LH、FSH,提早干预。

Objective To investigate the relationship between sex hormone levels and body mass index（BMI）in postmenopausal women with type 2 diabetes mellitus（T2DM）．Methods A total of 184 cases of natural postmenopausal women with T2DM admitted to our hospital from January 2022 to January 2023 were randomly selected,including 23 cases of obesity,74 cases of over weight and 87 cases of normal BMI．The clinical data and sex hormones among the three groups were analyzed．Results Waist circumference,fasting plasma glucose（FPG）,triglyceride,high density lipoprotein cholesterol,uric acid,follicle-stimulating hormone（FSH）,luteinizing hormone（LH）and oestrogen（E₂）levels were significantly different among the three groups（P<0.05）．E₂ levels of the obesity group and the over weight group were significantly higher than that of the normal group,while FSH and LH levels were significantly lower than that of the normal group．There was no significant difference in age,hemoglobin A1c,systolic blood pressure,diastolic blood pressure,total cholesterol,low density lipoprotein cholesterol,prolactin,testosterone and progesterone levels among the three groups（P>0.05）．Logistic regression analysis showed that higher waist circumference and lower FSH and LH levels were significantly correlated with obesity in postmenopausal women with T2DM．Conclusions Abdominal obesity should be controlled in postmenopausal women with T2DM,and LH and FSH should be periodically reviewed,in order to treat in advance．

目的 探究乙型病毒性肝炎不同状态合并2型糖尿病患者的临床特点。方法 对62例乙型肝炎病毒携带合并2型糖尿病(组1)、129例乙型病毒性肝炎合并2型糖尿病(组2)和83例乙型病毒性肝炎肝硬化合并2型糖尿病(组3)患者的临床资料进行回顾性分析。结果 各组间在性别和年龄上差异有统计学意义(χ²=11.133、P=0.004,F=7.640、P=0.001)。3组研究对象糖化血红蛋白(HbA1c)、总胆固醇(Tch)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血清白蛋白(ALB)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)和总胆汁酸(TBA)水平差异有统计学意义(F=4.028、P=0.019,F=4.140、P=0.017,F=3.172、P=0.044,F=6.701、P=0.002,F=53.156、P<0.001,F=4.920、P=0.008,F=4.173、P=0.017,F=7.181、P=0.001,F=9.170、P<0.001)。进一步两两比较,肝炎肝硬化组HbA1c、Tch 、LDL-C、ALB水平降低,但TBIL、IBIL、TBA增高,分别与另2组比较差异有统计学意义(P<0.05);组2空腹血糖(FBG)、HDL-C水平最高,前者高于组1,后者高于组3。各组糖尿病并发症居前三的都是周围神经病变、糖尿病肾病和糖尿病视网膜病变。结论 乙型病毒性肝炎合并2型糖尿病时其不同状态间具有不同的疾病特点,主要体现在携带状态Tch、TG、LDL-C高水平,肝炎状态FBG高水平,肝炎肝硬化状态HbAlc、ALB低水平但胆红素、胆汁酸水平高,在糖尿病并发症方面均以周围神经病变、糖尿病肾病和糖尿病视网膜病变为主。

Objective To study the clinical feature of different viral hepatitis B status with type 2 diabetes. Methods A retrospective analysis was carried out on 62 hepatitis B virus carriers with type 2 diabetes (group 1),129 viral hepatitis B patients with type 2 diabetes (group 2) and 83 viral hepatitis B cirrhosis patients with type 2 diabetes (group 3). Results The differences in gender and age among the three groups were significantly different (χ²=11.133, P=0.004 and F=7.640,P=0.001). The levels of HbA1c, total cholesterol (Tch), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), serum albumin (ALB), total bilirubin(TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL)and total bile acid (TBA)in three groups were significantly different (F=4.028, P=0.019.F=4.140, P=0.017.F=3.172, P=0.044.F=6.701, P=0.002.F=53.156, P<0.001.F=4.920, P=0.008.F=4.173, P=0.017.F=7.181, P=0.001.F=9.170, P<0.001). In further pairwise comparison, the levels of HbA1c, Tch, LDL-C and ALB of group 3 decreased significantly compared with other two groups, but the levels of TBIL, IBIL and TBA increased, with significant differences.The levels of fasting blood glucose(FBG) and HDL-C in group 2 were the highest,and the FBG was significantly higher than that in group 1, while the HDL-C was significantly higher than that in group 3.In the three groups, the top three diabetic complications were peripheral neuropathy, diabetic nephropathy and diabetic retinopathy. Conclusion Different statuses of viral hepatitis B with type 2 diabetes had different disease characteristics, mainly reflected in the high levels of Tch, TG and LDL-C in the hepatitis B virus carriers, high FBG level in the viral hepatitis B patients, low levels of HbAlc and ALB but high levels of bilirubin and bile acid in the cirrhosis patients.Peripheral neuropathy, diabetic nephropathy and diabetic retinopathy were the main complications of diabetes.

目的 探究2型糖尿病患者的肾糖阈(RTG)及相关因素。方法 本院对2014年12月—2018年9月466例2型糖尿病患者为研究对象,正常肾糖阀值为8.9～10 mmol/L,据此将患者分为高阀值组、中等阀值组以及低阀值组,不同组肾糖范围分别为RTG＞10 mmol/L、8.9 mmol/L≤RTG≤10 mmol/L、RTG＜8.9 mmol/L,以此对各组生化特征进行分析。结果 高阀值组与中等阀值组相比,RTG值、年龄、病程、空腹血糖(FPG)、体质量指数(BMI)、总胆固醇(TC)、血糖均值(MBG)、24 h血糖对比差异明显,P＜0.05。高阀值组与低阀值组相比,RTG值、性别、FPG、BMI、TC、MBG、糖化血红蛋白(HbA1C)对比有差异,P＜0.05。性别、年龄、BMI、HbA1C、TC以及低密度酶蛋白胆固醇(LDL-C)与2型糖尿病相关,且呈正比关系,P＜0.05;通过多元线性回归分析发现,2型糖尿病的影响因素主要有BMI、HbA1C、LDL-C,数据具有统计学意义,P＜0.05。结论 较多2型糖尿病患者肾糖阀值较高,且肾糖阀值与HbA1C、LDL-C相关。

目的 观察新疆石河子地区绝经后女性2型糖尿病(T2DM)患者糖、脂、骨代谢特征及骨密度(BMD)情况,探讨该人群中低密度脂蛋白受体相关蛋白5(LRP5)基因rs3736228、rs3781586位点的基因多态性及突变与糖、脂、骨代谢指标的关系。方法 将新疆石河子地区2016年10月—2017年10月社区、医院门诊及住院绝经后女性按照纳入标准和排除标准选取136例为研究对象,根据患者病史、糖耐量实验及骨密度仪测定骨密度分4组,糖耐量正常与骨量正常组(A组),糖耐量正常与骨量异常组(B组),T2DM与骨量正常组(C组),T2DM与骨量异常组(D组)。测定并记录患者年龄、绝经年限等基线资料,计算体质指数(BMI)等,并检测糖代谢指标(空腹血糖等)、骨代谢指标(血Ca等)、脂代谢指标(甘油三酯等)。采用MALDI-TOF-MS法测定LRP5基因该两个位点基因多态性并进行统计分析。结果 ①糖代谢指标:与A组比较,C组、D组FPG、HbA1c均高于A组(P<0.01)。脂代谢指标:与A组比较,B组、D组TG低于A组(P<0.05)。骨代谢指标:与A组比较,B组、D组BMD(L1-4)、BMD(股骨颈)低于A组(P<0.01)。②LRP5基因该两个位点SNP基因分型分布符合Hardy-Weinberg遗传平衡定律(P>0.05);同时,该两个位点不同基因型的分布频率和等位基因频率在组间的比较经Pearson Chi-Square检验后发现暂无显著差异(P>0.05)。③LRP5基因rs3736228位点:A组,与CC型(野生型)相比,CT/TT型(突变型)甘油三酯(TG)降低(P<0.05),BMD(L1-4)降低(P<0.05);C组,与CC型(野生型)相比,CT/TT型(突变型)高密度脂蛋白(HDL-C)升高(P<0.01),磷(P)升高(P<0.05);LRP5基因rs3781586位点:B组,与GG型(野生型)相比,GT/TT(突变型)高密度脂蛋白(HDL-C)升高(P<0.05)。结论 在新疆石河子地区绝经后女性2型糖尿病人群中,LRP5基因rs3736228、rs3781586位点的基因多态性可能与糖代谢无关,但LRP5基因rs3736228位点的突变可能与脂代谢(TG、HDL-C)、骨代谢(P、BMD)有关,rs3781586位点的突变可能与脂代谢(HDL)有关。

Objective To observe the characteristics of glucose, lipid and bone metabolism and bone mineral density (BMD)in postmenopausal women with type 2 diabetes mellitus (T2DM)in Shihezi district of Xinjiang province, and to investigate the relationship in the polymorphism and mutation of rs3736228 and rs3781586 of LRP5 gene and glucose,lipid and bone metabolism indexes in this population. Method A total of 136 postmenopausal Han women, who were related in the outpatient department, community, and hospital after hospitalization in Shihezi district of Xinjiang province from October 2016 to October 2017, were selected as the study subjects by the inclusion criteria and exclusion criteria.According to the patient's medicalhistory, glucosetolerance test results and bone mineral density (BMD), they were divided into 4 groups: normal glucose tolerance and normal bone mass (group A), normal glucose tolerance and abnormal bone mass (group B), type 2 diabetes and normal bone mass (group C), and type 2 diabetes mellitus and abnormal bone mass (group D). Baseline data such as patient's age, menopause years were measured and recorded, and body mass index (BMI)was calculated. Simultaneously, glucose metabolism indicators including fasting blood glucose (FBG, etc), bone metabolism indicators (blood Ca, etc), lipid metabolism indicators(triglycerides, etc)were detected. The polymorphisms of rs3736228 and rs3781586 of LRP5 gene were determined by Maldi-Tof-Ms and those data were analyzed statistically. Results ①Glucose metabolism index: compared with group A: FPG and HbAlc in group C, group D were all higher than group A (P<0.01). Lipid metabolism index: compared with group A, TG in group B and group D was lower than that in group A (P<0.05). Bone metabolism index: compared with group A, BMD (L1- 4)and BMD (femoral neck)in group B and group D were lower than those in group A (P<0.01). ②The distribution of SNP genotypes at rs3736228, rs3781586 of LRP5 conformsed to the Hardy-Weinberg genetic equilibrium law (P>0.05). The distribution frequency and allele frequency of LRP5 genotypes rs3736228, rs3781586 were compared among the groups. Pearson chi-square test showed no significant difference (P>0.05). ③Rs 3736228 locus of LRP5 gene:in group A, compared with CC (wild type), CT/TT (mutated type)triglyceride (TG)decreased (P<0.05), BMD (L1- 4)decreased (P<0.05). In group C, compared with CC (wild type), CT/TT (mutated type)high-density lipoprotein (HDL-C)increased (P<0.05), phosphorus increased (P<0.05). Rs 3781586 locus of LRP5 gene: in group B, compared with GG (wild type), GT/TT (mutated type)high-density lipoprotein (HDL-C)increased (P<0.05).Conclusion In the Xinjiang Shihezi district among postmenopausal women with type 2 diabetes, rs3736228, rs3781586 loci of LRP5 gene polymorphism may be irrelevant to glucose metabolism, but the mutation of rs3736228 of LRP5 gene locus may be related to lipid metabolism and bone metabolism (TG, HDL-C, BMD, P), and the mutation of rs3781586 may be related to lipid metabolism (HDL-C).

目的 探讨瑞格列奈联合胰岛素治疗2型糖尿病临床疗效及对患者血糖水平的影响效果。方法 选取我院2019年1月—2021年1月收治的2型糖尿病患者324例,用随机数字法分为两组,每组各52例,对照组应用胰岛素治疗,研究组应用瑞格列奈联合胰岛素治疗。对两组2型糖尿病患者的临床疗效、血糖水平(FPG指数、2 h PG指数、HbA1c指数)以及胰岛素水平(HOMA-β水平、HOMA-IR水平)进行比较。结果 研究组疗效高于对照组(P＜0.05);研究组治疗后血糖指数优于对照组(P＜0.05);研究组治疗后胰岛素水平优于对照组(P＜0.05)。结论 2型糖尿病患者在治疗时,应用瑞格列奈联合胰岛素治疗,可增强治疗疗效,有效控制血糖水平,改善胰岛功能,从而促进疾病转归,具有极大的推广价值。

Objective To investigate the clinical efficacy of repaglinide combined with insulin in the treatment of type 2 diabetes mellitus and its effect blood glucose level. Methods A total of 324 patients with type 2 diabetes admitted to our hospital from January 2019 to January 2021 were randomly divided into two groups with 52 patients in each group. The control group was treated with insulin, and the research group was treated with repaglinide combined with insulin. Clinical efficacy, blood glucose level (FPG index, 2HPG index, HbA1c index) and insulin level (HOMA-β level, HOMA-IR level) of patients with type 2 diabetes were compared between two groups. Results The therapeutic effect of the research group was higher than that of the control group (P<0.05). The glycemic index of the research group was better than that of the control group (P<0.05). The insulin level in the research group was better than that in the control group (P<0.05). Conclusion In the treatment of type 2 diabetes mellitus, the application of repaglinide combined with insulin can enhance the therapeutic effect, effectively control the blood glucose level, improve the islet function, so as to promote the outcome of the disease, which has great promotion value.

目的 分析绝经前后女性2型糖尿病(type 2 diabetes mellitus,T2DM)患者C肽水平与代谢综合征(metabolic syndrome,MS)的关系。方法 选定本院2019年3月—2021年3月接诊的64例绝经前后T2DM患者作为试验组,以及同期门诊体检的64例健康女性作为参照组,检测并比较两组空腹C肽、餐后2 h C肽、血糖指标、血清炎症指标、血脂指标、血压指标,比较两组MS发生率,Pearson分析空腹C肽、餐后2 h C肽与血糖指标、血清炎症指标、血脂、血压的相关性。结果 试验组空腹C肽、餐后2h C肽、餐后2 h 血糖、空腹血糖、白细胞计数、TNF-α、IL-6、LDL-C、甘油三酯、总胆固醇、收缩压、舒张压均高于参照组,试验组HDL-C低于参照组,P＜0.05。试验组MS发生率(12.50%)高于参照组(1.56%),P＜0.05。空腹C肽、餐后2 h C肽与2 h PG、FPG、WBC、TNF-α、IL-6、LDL-C、TG、TC、SBP、DBP呈正相关性,与HDL-C呈负相关性,P＜0.05。结论 绝经前后T2DM患者普遍存在血脂、血压、血糖代谢紊乱及炎症反应,C肽水平增高会增加MS发生率,应当引起临床重视。

Objective To analyze the relationship between C-peptide and metabolic syndrome (MS) in premenopausal and postmenopausal women with type 2 diabetes mellitus (T2DM). Methods A total of 64 premenopausal and postmenopausal T2DM patients in our hospital from March 2019 to March 2021 were included in the experimental group, and 64 healthy women in the same period were selected as the control subjects. Fasting C-peptide, postprandial 2h C-peptide and blood glucose, serum inflammatory factors, blood lipid and blood pressure were detected and compared between the two groups. The incidence of MS was compared between the two groups. The relationship among fasting C-peptide, postprandial 2h C-peptide and blood glucose, serum inflammation, blood lipid and blood pressure were analyzed by Pearson correlation. Results Fasting C-peptide,postprandial 2h C-peptide, 2hPG, FPG, WBC, TNF-a, IL-6, LDL-C, TG, TC, SBP, DBP of the experimental group were higher than those of the control group. HDL-C of the experimental group was lower than that of the control group, P<0.05. The incidence of MS in the experimental group (12.50%) was higher than that in the control group (1.56%), P< 0.05. Fasting C-peptide and postprandial 2h C-peptide were positively correlated with 2hPG, FPG, WBC, TNF-a, IL-6, LDL-C, TG, TC, SBP and DBP, and negatively correlated with HDL-C (P<0.05). Conclusion The metabolic disorder of blood lipid, blood pressure, blood glucose and inflammatory reaction were common in T2DM patients before and after menopause. The increase of C-peptide level would increase the incidence of MS, which should be paid attention in clinic practice.