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将196例新诊断为T2DM的患者按HbA1c水平分为1组(HbA1c≤7.5%)、2组(HbA1c<9.0%)和3组(HbA1c≥9.0%)。采用HOMA-β,HOMA-IR评价基础胰岛素分泌功能和IR程度。采用ΔI130/ΔG30、INSAUC评价第一相胰岛素分泌功能。结果①校正性别、年龄、BMI后,随HbA1c的升高,HOMA-β及第一相胰岛素分泌下降,HbA1c≥9.0%组HOMA-IR较1组、2组升高。②HOMA-β、ΔI130/ΔG30、INSAUC与血糖、HbA1c、TG成负相关;HOMA-IR与血糖、BMI、TG正相关。③多元逐步回归分析显示,FPG、BMI和HbA1c是HOMA-β的独立影响因素;BMI、HbA1c和TG是ΔI130/ΔG30的独立影响因素;腰围、FPG、BMI是INSAUC的独立影响因素;BMI、TG、是HOMA-IR的独立影响因素。结论T2DM患者存在胰岛素分泌缺陷及IR,两种情况在HbA1c水平较高者中尤为显著。
196 patients with newly diagnosed T2DM were divided into 1 group (HbA1c≤7.5%), 2 groups (HbA1c <9.0%) and 3 groups (HbA1c≥9.0%) according to the level of HbA1c. HOMA-β and HOMA-IR were used to assess basal insulin secretion and IR. Using ΔI130 / ΔG30, INSAUC was used to assess first-phase insulin secretion. Results ① After adjusting for sex, age, and BMI, HOMA-β and insulin secretion decreased with the increase of HbA1c, and HOMA-IR increased with HbA1c≥9.0% compared with group 1 and 2. HOMA-β, ΔI130 / ΔG30, INSAUC were negatively correlated with blood glucose, HbA1c, TG; HOMA-IR was positively correlated with blood glucose, BMI and TG. Multiple linear regression analysis showed that FPG, BMI and HbA1c were independent factors of HOMA-β; BMI, HbA1c and TG were independent factors of ΔI130 / ΔG30; waist circumference, FPG and BMI were independent influencing factors of INSAUC; , Is an independent factor of HOMA-IR. Conclusion T2DM patients have insulin secretion deficit and IR, the two cases are particularly significant in the higher HbA1c levels.