Wu Tiantian, Wang Qiang, Pu Changsheng, Zhang Keming
Department of Hepatobiliary Surgery, Peking University International Hospital, Beijing 100001, China.
Biomedicines. 2023 Oct 19;11(10):2840. doi: 10.3390/biomedicines11102840.
This study aimed to analyze the correlation between islet β cell function and gallbladder stone (GBS) in newly diagnosed type 2 diabetes mellitus (T2DM) patients.
A total of 438 newly diagnosed T2DM patients in Peking University International Hospital from January 2017 to August 2022 were retrospectively analyzed and divided into a non-GBS group and a GBS group.
(1) The homeostasis model assessment of the insulin resistance (HOMA-IR) of the GBS group was higher than that of the non-GBS group ( < 0.05), while the homeostasis model assessment of β cell (HOMA-β), disposition index (DI0), and Matsuda index of the GBS group were lower than those of the non-GBS group (all < 0.05). (2) For male patients, HOMA-IR is an independent risk factor for GBS (OR = 2.00, 95% CI:1.03, 3.88, < 0.05), and the Matsuda index value is a protective factor for GBS (OR = 0.76, 95% CI:0.60, 0.96, < 0.05). For female patients, HOMA-IR is an independent risk factor for GBS (OR = 2.80, 95% CI:1.03, 7.58, < 0.05) and the Matsuda index value is a protective factor for GBS (OR = 0.59, 95% CI:0.39, 0.90, < 0.05). (3) For male patients, the area under curve (AUC) for predicting GBS was 0.77 (95% CI 0.67, 0.87), with a specificity of 75.26%, a sensitivity of 80.00%, and an accuracy of 75.64%. For female patients, the AUC for predicting GBS was 0.77 (95% CI 0.63, 0.88), with a specificity of 79.63%, a sensitivity of 71.43%, and an accuracy of 78.69%.
Insulin resistance may be an independent risk factor for the incidence of GBS in patients with newly diagnosed T2DM, both male or female, which provides a new clinical basis and research direction for the prevention and treatment of GBS in patients with T2DM. This study has established a predictive model of GBS in T2DM and found it to be accurate, thus representing an effective tool for the early prediction of GBS in patients with T2DM.
本研究旨在分析新诊断2型糖尿病（T2DM）患者胰岛β细胞功能与胆囊结石（GBS）之间的相关性。
回顾性分析2017年1月至2022年8月北京大学国际医院438例新诊断的T2DM患者，并将其分为非GBS组和GBS组。
（1）GBS组胰岛素抵抗的稳态模型评估（HOMA-IR）高于非GBS组（<0.05），而GBS组β细胞稳态模型评估（HOMA-β）、处置指数（DI0）和松田指数低于非GBS组（均<0.05）。（2）对于男性患者，HOMA-IR是GBS的独立危险因素（OR = 2.00，95%CI：1.03，3.88，<0.05），松田指数值是GBS的保护因素（OR = 0.76，95%CI：0.60，0.96，<0.05）。对于女性患者，HOMA-IR是GBS的独立危险因素（OR = 2.80，95%CI：1.03，7.58，<0.05），松田指数值是GBS的保护因素（OR = 0.59，95%CI：0.39，0.90，<0.05）。（3）对于男性患者，预测GBS的曲线下面积（AUC）为0.77（95%CI 0.67，0.87），特异性为75.26%，敏感性为80.00%，准确性为75.64%。对于女性患者，预测GBS的AUC为0.77（95%CI 0.63，0.88），特异性为79.63%，敏感性为71.43%，准确性为78.69%。
胰岛素抵抗可能是新诊断T2DM患者发生GBS的独立危险因素，无论男性还是女性，这为T2DM患者GBS的防治提供了新的临床依据和研究方向。本研究建立了T2DM患者GBS的预测模型，发现其具有准确性，是早期预测T2DM患者GBS的有效工具。
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