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2型糖尿病患者糖化血红蛋白与稳态模型评估指标的相关性:基于糖化血红蛋白预测β细胞功能

Correlation Between Glycated Hemoglobin and Homa Indices in Type 2 Diabetes Mellitus: Prediction of Beta-Cell Function from Glycated Hemoglobin.

作者信息

Al-Hakeim Hussein Kadhem, Abdulzahra Mohammed Saied

机构信息

College of Science, Kufa University, Iraq.

Dean of the College of Medicine, Kufa University, Iraq.

出版信息

J Med Biochem. 2015 Apr;34(2):191-199. doi: 10.2478/jomb-2014-0033. Epub 2015 Mar 3.

Abstract

BACKGROUND

The present study aimed to determine the most efficient insulin resistance function related to glycemic control expressed as glycated hemoglobin (HbA1c) in type 2 diabetes mellitus patients (T2DM). The other aim is to derive equations for the prediction of beta cell functions containing HbA1c as a parameter in addition to fasting glucose and insulin.

METHODS

T2DM Patients were grouped according to the following: (1) degree of control (good, fair, and poor control) and (2) insulin resistance as observed in obtained data and significant differences revealed by the homeostasis model assessment (HOMA) of related parameters (insulin resistance = HOMA2IR, beta-cell function = HOMA%B, and insulin sensitivity = HOMA%S) among groups. Correlations and forecasting regression analysis were calculated.

RESULTS

HbA1c was found to be correlated with insulin resistance parameters in T2DM subgroups. This correlation was also significantly correlated with HOMA%B and the quantitative insulin sensitivity check index (QUICKI) in fair and poor control groups. Regression analysis was used to predict the forecasting equations for HOMA%B. The best applicable equations were derived for healthy control (HOMA2%B=-1.76FBG+5.00Insulin+4.69HbA1c+189.84) and poor control groups (HOMA2%B=0.001 FBG+0.5Insulin-8.67HbA1c+101.96). These equations could be used to predict β-cell function (HOMA%B) after FBG, insulin and HbA1c values were obtained for healthy and poor control groups. In the good and fair control groups, the applicability of the HOMA model fails to yield appropriate results.

CONCLUSIONS

Beta-cell function is correlated with QUICKI and HbA1c and could be predicted properly from HbA1c, insulin, and glucose in the healthy and poor control groups. New regression equations were established that involve HbA1c.

摘要

背景

本研究旨在确定2型糖尿病患者(T2DM)中与糖化血红蛋白(HbA1c)所表示的血糖控制相关的最有效胰岛素抵抗功能。另一个目的是推导除空腹血糖和胰岛素外还包含HbA1c作为参数的β细胞功能预测方程。

方法

T2DM患者按以下方式分组:(1)控制程度(良好、一般和差);(2)根据获得的数据观察到的胰岛素抵抗以及相关参数(胰岛素抵抗 = HOMA2IR,β细胞功能 = HOMA%B,胰岛素敏感性 = HOMA%S)的稳态模型评估(HOMA)所揭示的组间显著差异。计算相关性和预测回归分析。

结果

发现HbA1c与T2DM亚组中的胰岛素抵抗参数相关。在一般和差控制组中,这种相关性也与HOMA%B和定量胰岛素敏感性检查指数(QUICKI)显著相关。使用回归分析预测HOMA%B的预测方程。得出了适用于健康对照组(HOMA2%B = -1.76空腹血糖 + 5.00胰岛素 + 4.69HbA1c + 189.84)和差控制组(HOMA2%B = 0.001空腹血糖 + 0.5胰岛素 - 8.67HbA1c + 101.96)的最佳方程。对于健康组和差控制组,在获得空腹血糖、胰岛素和HbA1c值后,这些方程可用于预测β细胞功能(HOMA%B)。在良好和一般控制组中,HOMA模型的适用性未能产生合适的结果。

结论

β细胞功能与QUICKI和HbA1c相关,并且在健康组和差控制组中可以根据HbA1c、胰岛素和葡萄糖进行适当预测。建立了包含HbA1c的新回归方程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d20/4922324/41c7294be5f3/jomb-2014-0033f1.jpg

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