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β细胞功能与 2 型糖尿病患者未来血糖控制的关系。

Association between beta cell function and future glycemic control in patients with type 2 diabetes.

机构信息

Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.

出版信息

Endocr J. 2013;60(4):517-23. Epub 2012 Dec 26.

Abstract

The aim of this study was to clarify the association between C-peptide immunoreactivity (CPR), a marker of beta cell function, and future glycemic control in patients with type 2 diabetes. We conducted a retrospective analysis of 513 consecutive patients with type 2 diabetes who were admitted to our hospital between 2000 and 2007 and followed up for 2 years. Serum and urinary CPR levels were measured during admission, and CPR index was calculated as the ratio of CPR to plasma glucose. The associations between these markers at baseline and glycemic control after 2 years were assessed by means of logistic regression models. After 2 years, 167 patients (32.6%) showed good glycemic control (HbA1c <6.9%). Baseline serum and urinary CPR indices were significantly associated with good glycemic control after 2 years, and the postprandial CPR to plasma glucose ratio (postprandial CPR index) showed the strongest association (odds ratio (OR) 1.29, 95% confidence interval (CI) 1.12-1.50, P = 0.001) among CPR indices. Multivariate analyses showed consistent results (OR 1.23, 95%CI 1.03-1.48, P = 0.021). In conclusion, preserved beta cell function at baseline was associated with better glycemic control thereafter in patients with type 2 diabetes.

摘要

本研究旨在阐明 C 肽免疫反应性(CPR)作为β细胞功能的标志物与 2 型糖尿病患者未来血糖控制之间的关系。我们对 2000 年至 2007 年间我院收治的 513 例连续 2 型糖尿病患者进行了回顾性分析,并进行了 2 年随访。入院时测定血清和尿 CPR 水平,并计算 CPR 指数作为 CPR 与血糖的比值。采用逻辑回归模型评估这些标志物在基线时与 2 年后血糖控制之间的关系。2 年后,167 例患者(32.6%)血糖控制良好(HbA1c<6.9%)。基线时血清和尿 CPR 指数与 2 年后良好的血糖控制显著相关,而餐后 CPR 与血糖的比值(餐后 CPR 指数)与其他 CPR 指数相比相关性最强(比值比(OR)为 1.29,95%置信区间(CI)为 1.12-1.50,P=0.001)。多变量分析得到了一致的结果(OR 为 1.23,95%CI 为 1.03-1.48,P=0.021)。综上所述,2 型糖尿病患者基线时β细胞功能良好与随后的血糖控制改善相关。

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