Guo Hang, Ma Chunlei, Wu Xiaoming, Pan Congqing
NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.
Department of Urology, Tianjin 4th Center Hospital, The Fourth Central Hospital Affiliated to Nankai University, Tianjin 300140, China.
Int J Endocrinol. 2021 Aug 17;2021:9976067. doi: 10.1155/2021/9976067. eCollection 2021.
To investigate the functional status of pancreatic and cells in Type 2 diabetes mellitus (T2DM) patients with different plasma triglyceride (TG) levels. TG levels can be prognostic markers for T2DM.
A total of 328 patients with T2DM were divided into three groups according to different TG levels: the TGL group: TG < 1.7 mmol/L; TGM group: 1.7 mmol/L ≤ TG < 2.3 mmol/L; and TGH group: TG ≥ 2.3 mmol/L. An oral glucose tolerance test (OGTT), insulin release test, and glucagon release test were performed in each patient. The changes of glucagon, glucagon/insulin ratio, early insulin secretion index (Δ /Δ ), and area under the insulin curve (AUC) were compared among each group. Also, the correlations between glucagon and pancreatic -cell function, glycosylated hemoglobin (HbA1c), and other indices were analyzed.
With the increase of TG, the fasting and postprandial glucagon levels, the glucagon/insulin ratio, and the area under the glucagon curve (AUC) presented an increasing trend. The homeostasis model assessment of insulin resistance (HOMA-IR) of the TGH group was significantly increased compared to the TGL and TGM groups. In addition to the increase in TG levels, the insulin sensitivity index (ISI), homeostasis model assessment for -cell function index (HOMA-), Δ /Δ , and AUC displayed a reducing trend. Glucagon was negatively correlated with Δ /Δ , high-density lipoprotein (HDL), HOMA-, body mass index (BMI), ISI, and AUC ( < 0.05) and positively correlated with fasting blood glucose (FPG), AUC, HOMA-IR, HbA1c, duration, TG, low-density lipoprotein (LDL), and total cholesterol (TC) ( < 0.05).
Hypertriglyceridemia aggravated the dysfunction of pancreatic and cells. A reasonable control of the TG level makes it easier for blood glucose to reach the standard.
探讨不同血浆甘油三酯（TG）水平的2型糖尿病（T2DM）患者胰腺α细胞和β细胞的功能状态。TG水平可作为T2DM的预后标志物。
将328例T2DM患者根据不同TG水平分为三组：TGL组：TG＜1.7 mmol/L；TGM组：1.7 mmol/L≤TG＜2.3 mmol/L；TGH组：TG≥2.3 mmol/L。对每位患者进行口服葡萄糖耐量试验（OGTT）、胰岛素释放试验和胰高血糖素释放试验。比较各组胰高血糖素、胰高血糖素/胰岛素比值、早期胰岛素分泌指数（ΔI30/ΔG30）及胰岛素曲线下面积（AUC）的变化。同时，分析胰高血糖素与胰腺β细胞功能、糖化血红蛋白（HbA1c）及其他指标的相关性。
随着TG升高，空腹及餐后胰高血糖素水平、胰高血糖素/胰岛素比值及胰高血糖素曲线下面积（AUC）呈上升趋势。TGH组的胰岛素抵抗稳态模型评估（HOMA-IR）较TGL组和TGM组显著升高。除TG水平升高外，胰岛素敏感指数（ISI）、β细胞功能稳态模型评估指数（HOMA-β）、ΔI30/ΔG30及AUC呈下降趋势。胰高血糖素与ΔI30/ΔG30、高密度脂蛋白（HDL）、HOMA-β、体重指数（BMI）、ISI及AUC呈负相关（P＜0.05），与空腹血糖（FPG）、AUC、HOMA-IR、HbA1c、病程、TG、低密度脂蛋白（LDL）及总胆固醇（TC）呈正相关（P＜0.05）。
高甘油三酯血症加重了胰腺α细胞和β细胞功能障碍。合理控制TG水平有助于血糖达标。
