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纳入对象为234例初诊2型糖尿病患者和102例健康体检者。测量身高、体重、腰围、臀围;检测肝酶、糖脂代谢指标;计算体重指数(BMI)、腰臀比(WHR)以及改良的胰岛素C肽指数(HOMA-C肽)。结果初诊T2DM组腰围(WC)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、空腹C肽(FCP)、甘油三酯(TG)、总胆固醇(TC)明显高于健康对照组(P<0.01),γ-谷氨酰胺转肽酶(GGT)、HOMA-C肽亦明显高于健康对照组(P<0.05);高密度脂蛋白胆固醇(HDL-C)明显低于健康对照组(P<0.01)。而两组的性别、年龄、身高、体重、BMI、臀围、WHR、低密度脂蛋白胆固醇(LDL-C)、谷草转氨酶(AST)、谷丙转氨酶(ALT)比较均无统计学差异。Pearson相关分析显示,HOMA-C肽与WC、GGT、TG呈显著正相关,相关系数分别是0.278、0.397、0.343(P均<0.01)。多元逐步线性回归分析显示,WC、TG、GGT与HMOA-C肽密切相关。在初诊T2DM组,高GGT组(HGGT)的WC、TG、TC、HOMA-C肽较正常GGT组(NGGT)明显升高,Logistic回归分析显示,在校正年龄、性别、WC和血清TG、TC等影响因素后,HGGT组患糖尿病的风险是NGGT组的1.745倍(OR值=1.745,95%CI:1.071～3.710)。结论:GGT与IR密切相关,GGT可以作为IR及T2DM发生危险的预测指标。
The subjects were 234 newly diagnosed type 2 diabetic patients and 102 healthy subjects. Body height, body weight, waist circumference and hip circumference were measured. Liver enzymes and glucose and lipid metabolism were measured. Body mass index (BMI), WHR, and modified insulin C peptide index (HOMA-C peptide) were calculated. Results The WC, FPG, HbA1c, FCP, TG and TC in newly diagnosed T2DM patients were significantly higher than those in healthy controls (P <0.01) ), GGT and HOMA-C were also significantly higher than those in the healthy controls (P <0.05); HDL-C was significantly lower than that of the healthy controls (P < 0.01). There was no significant difference in gender, age, height, weight, BMI, hip circumference, WHR, LDL-C, AST and ALT between the two groups. Pearson correlation analysis showed that there was a significant positive correlation between HOMA-C peptide and WC, GGT and TG, the correlation coefficients were 0.278, 0.397 and 0.343, respectively (all P <0.01). Multivariate stepwise linear regression analysis showed that WC, TG, GGT and HMOA-C peptide are closely related. In newly diagnosed T2DM group, WC, TG, TC and HOMA-C peptide in high GGT group (HGGT) were significantly higher than those in normal GGT group (NGGT). Logistic regression analysis showed that there was no significant difference in age, gender, WC, The risk of diabetes in HGGT group was 1.745 times that of NGGT group (OR = 1.745, 95% CI: 1.071-3.710). Conclusion: GGT is closely related to IR, and GGT can be used as a predictor of risk of IR and T2DM.