Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Diabetes Technol Ther. 2012 Nov;14(11):1033-42. doi: 10.1089/dia.2012.0144. Epub 2012 Sep 7.
This study investigated the incidence of β-cell dysfunction and the clinical and biochemical factors affecting that in patients with type 2 diabetes having more than 3 years of follow-up.
β-Cell dysfunction was assessed by measuring changes in the fasting serum C-peptide concentrations. Patients were classified into two groups: cases showing a decreased (Group D) or an unchanged or increased (Group I) C-peptide concentration from the baseline.
Of the 504 patients included in this study, 259 (51%) showed decreased C-peptide concentrations, of whom 20% showed a decrease of ≥50%. Most patients, however, had a final C-peptide concentration of ≥1 ng/mL, with only 18 (4%) individuals having a level <0.6 ng/mL. Patients in Group D had a longer duration of diabetes, higher initial hemoglobin A1c concentration, and longer treatment durations with sulfonylurea and insulin compared with Group I. After adjusting for diabetes duration and C-peptide follow-up period, the duration of sulfonylurea treatment was found to be the only factor independently associated with decreases in the C-peptide concentration.
Although β-cell function deteriorates over time in patients with type 2 diabetes, these cases mainly have fasting serum C-peptide concentrations of ≥1 ng/mL. A longer treatment duration with sulfonylurea is associated with a more rapid decline in the C-peptide concentration.
本研究旨在调查患有 2 型糖尿病且随访时间超过 3 年的患者β细胞功能障碍的发生率，以及影响β细胞功能障碍的临床和生化因素。
通过测量空腹血清 C 肽浓度的变化来评估β细胞功能障碍。将患者分为两组：C 肽浓度降低组（D 组）和 C 肽浓度不变或升高组（I 组）。
本研究共纳入 504 例患者，其中 259 例（51%）C 肽浓度降低，其中 20%降低≥50%。然而，大多数患者的最终 C 肽浓度≥1ng/mL，只有 18 例（4%）患者的水平<0.6ng/mL。与 I 组相比，D 组患者的糖尿病病程较长，初始糖化血红蛋白浓度较高，且接受磺脲类药物和胰岛素治疗的时间更长。在校正糖尿病病程和 C 肽随访时间后，发现磺脲类药物治疗时间是与 C 肽浓度下降相关的唯一独立因素。
尽管 2 型糖尿病患者的β细胞功能随时间逐渐恶化，但这些患者的空腹血清 C 肽浓度主要≥1ng/mL。磺脲类药物治疗时间较长与 C 肽浓度下降更快相关。
