Hua Kai-Fang, Zhang Ming-You, Zhang Yao, Ren Bing-Jie, Wu Yan-Hui
Department of Endocrinology, Xiang' an Hospital of Xiamen University, Xiamen, Fujian, People' s Republic of China.
School of Medicine, Xiamen University, Xiamen, Fujian, People' s Republic of China.
Diabetes Metab Syndr Obes. 2022 Aug 9;15:2417-2425. doi: 10.2147/DMSO.S373475. eCollection 2022.
The purpose of our study was to analyze the characteristics of OGTT and the correlation between the insulin to C-peptide molar ratio (ICPR), HOMA-IR and insulin antibodies (IAs) in T2DM patients.
A total of 77 T2DM patients were included and divided into the IA+ group (25 patients) and IA- group (52 patients). The values of serum glucose, insulin, and C-peptide testing during 2-h OGTT were summarized comparatively, and ROC was made to analyze the predictive value of ICPR for IAs.
At each time point of OGTT, there was no significant difference in serum glucose and C-peptide changes (p>0.05). Serum insulin levels in positive patients were elevated or not at different time points of the OGTT but ICPR was significantly different (P<0.05) in the two groups. Spearman correlation coefficient analysis showed that the presence of insulin antibodies was correlated with ICPR, but not with HOMA-IR, and ICPR-2h had a better prediction capacity (AUC=0.735, the optimal cutoff-point=0.11, Se=0.760, Sp=0.635).
T2DM patients with IAs showed no difference in serum glucose and serum C-peptide changes, but elevated or not insulin levels on the OGTTs, compared with negative patients. ICPR-2h can be a preliminary diagnostic index to timely predict IAs in T2DM patients.
本研究旨在分析2型糖尿病（T2DM）患者口服葡萄糖耐量试验（OGTT）的特征以及胰岛素与C肽摩尔比（ICPR）、稳态模型评估的胰岛素抵抗指数（HOMA-IR）和胰岛素抗体（IAs）之间的相关性。
共纳入77例T2DM患者，分为IAs阳性组（25例）和IAs阴性组（52例）。比较总结2小时OGTT期间血清葡萄糖、胰岛素和C肽检测值，并绘制ROC曲线分析ICPR对IAs的预测价值。
在OGTT的各个时间点，血清葡萄糖和C肽变化无显著差异（p>0.05）。OGTT不同时间点阳性患者的血清胰岛素水平有升高或未升高的情况，但两组的ICPR有显著差异（P<0.05）。Spearman相关系数分析显示，胰岛素抗体的存在与ICPR相关，但与HOMA-IR无关，且ICPR-2h具有更好的预测能力（AUC=0.735，最佳截断点=0.11，灵敏度=0.760，特异度=0.635）。
与IAs阴性患者相比，IAs阳性的T2DM患者血清葡萄糖和血清C肽变化无差异，但OGTT时胰岛素水平有升高或未升高的情况。ICPR-2h可作为及时预测T2DM患者IAs的初步诊断指标。
