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在中国 2 型糖尿病患者中,通过毛细血管血糖评估时间在正常范围内与胰岛素敏感性和β细胞功能的关系:一项横断面研究。

Time in range assessed by capillary blood glucose in relation to insulin sensitivity and β-cell function in patients with type 2 diabetes mellitus: A cross-sectional study in China.

机构信息

Department of Ophthalmology, the Sixth Affiliated Hospital, South China University of Technology, Foshan, Guangdong Province, China.

Department of Endocrinology, the Sixth Affiliated Hospital, South China University of Technology, Foshan, Guangdong Province, China.

出版信息

J Diabetes Investig. 2022 Nov;13(11):1825-1833. doi: 10.1111/jdi.13876. Epub 2022 Jul 11.

Abstract

AIMS

This study investigated the association of capillary blood glucose (CBG)-assessed time in range (TIR) (3.9-10.0 mmol/L) with insulin sensitivity and islet β-cell function.

MATERIALS AND METHODS

We recruited 455 patients with type 2 diabetes mellitus. Seven-point glucose-profile data (pre- and 120 min post-main meals, bedtime) were collected over three consecutive days. Plasma glucose and serum insulin concentrations were measured at 0, 60, and 120 min after a 100 g standard steamed bread meal test. The homeostasis model assessment of insulin resistance (HOMA-IR) and Matsuda index were computed to evaluate insulin resistance. The HOMA of β-cell function (HOMA-β) and the area under the curve between insulin and blood glucose (IAUC /GAUC ) were used to estimate β-cell function.

RESULTS

TIR was positively correlated with the 60 and 120 min insulin values, IAUC , the Matsuda index, HOMA-β, and IAUC /GAUC (r : 0.154, 0.129, 0.137, 0.194, 0.341, and 0.334, respectively; P < 0.05) but inversely correlated with HOMA-IR (r : -0.239, P < 0.001). After adjusting for confounders, multinomial multiple logistic regression analysis revealed that the odds ratios (ORs) of achieving the target time in range (>70%) increased by 12% (95% confidence interval [CI]: 3-21%), 7% (95% CI: 1-14%), 10% (95% CI: 5-16%), and 45% (95% CI: 25-68%) for each 10 mIU/L increase in the 60 and 120 min insulin values, 10 unit increase in HOMA-β, and unit increase in IAUC /GAUC , respectively (P < 0.05). Nevertheless, the OR decreased by 10% (95% CI: 1-18%) for each unit increase in HOMA-IR (P < 0.05).

CONCLUSIONS

Insulin resistance and islet β-cell function are related to capillary blood glucose-assessed TIR.

摘要

目的

本研究旨在探讨毛细血管血糖评估的时间在范围内(TIR)(3.9-10.0mmol/L)与胰岛素敏感性和胰岛β细胞功能的关系。

材料与方法

我们招募了 455 名 2 型糖尿病患者。连续 3 天采集 7 点血糖谱数据(主餐前和 120 分钟后、睡前)。在 100g 标准馒头餐后 0、60 和 120 分钟测量血浆葡萄糖和血清胰岛素浓度。计算稳态模型评估的胰岛素抵抗(HOMA-IR)和 Matsuda 指数来评估胰岛素抵抗。用胰岛β细胞功能的 HOMA 评估(HOMA-β)和血糖胰岛素曲线下面积(IAUC/GAUC)来估计β细胞功能。

结果

TIR 与 60 分钟和 120 分钟胰岛素值、IAUC、Matsuda 指数、HOMA-β和 IAUC/GAUC 呈正相关(r:0.154、0.129、0.137、0.194、0.341 和 0.334,分别;P<0.05),但与 HOMA-IR 呈负相关(r:-0.239,P<0.001)。在调整混杂因素后,多变量多项逻辑回归分析显示,达到目标时间范围(>70%)的几率比(ORs)分别增加 12%(95%置信区间[CI]:3-21%)、7%(95% CI:1-14%)、10%(95% CI:5-16%)和 45%(95% CI:25-68%),与 60 分钟和 120 分钟胰岛素值各增加 10mIU/L、HOMA-β增加 10 单位和 IAUC/GAUC 增加 1 单位相关(P<0.05)。然而,HOMA-IR 每增加 1 个单位,OR 降低 10%(95% CI:1-18%)(P<0.05)。

结论

胰岛素抵抗和胰岛β细胞功能与毛细血管血糖评估的 TIR 有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c160/9623508/b7bfbc446bba/JDI-13-1825-g001.jpg

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