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侯进军邓齐文孙慧玲陈杰刘贤王书奎.生化指标与2 型糖尿病患者实验诊断及预后相关性研究[J].,2014,14(19):3651-3656

生化指标与2 型糖尿病患者实验诊断及预后相关性研究

Study on Association of Biochemical Criterion and Laboratory Diagnosiswith Related Prognosis in Type 2 Diabetic Patients

DOI：

中文关键词: 2 型糖尿病 BMI 糖化血红蛋白肥胖

英文关键词: Type 2 diabetes Body mass index Glycated hemoglobin Obesity

基金项目:国家自然科学基金项目（81172141）

作者	单位
侯进军邓齐文孙慧玲陈杰刘贤王书奎	南京医科大学附属南京医院中心实验室南京市迈皋桥医院南京师范大学生命科学学院

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中文摘要:

目的：研究BMI、HbA1c、病程、相关代谢指标与2 型糖尿病（T2DM）诊断及预后的关系。方法：收集379 例T2DM 患者与 383 例健康体检者，采用生化分析仪分析二组人群的生化指标，采用高效液相色谱法检测T2DM 组HbA1c 水平，胰岛素及C 肽采用电化学发光法检测。计量资料采用t 检验、单因素方差及相关性分析，计数资料采用卡方检验分析。结果：对各组结果进行比较显示（1）T2DM 患者的BMI、FBG、TG、LDL-C、BUN、UA、HbA1c 水平明显高于正常对照组（P均<0.01)，HDL-C、CREA 水平明显低于对照组（P均<0.01)；（2 ）TC、LDL-C、BUN、CREA及2hINS 与年龄相关。（3）肥胖组的TG、CREA、UA、FCP、2hCP 高于非肥胖组（P 均<0.05)；（4 ）初诊T2DM 患者的FBG、TG、HbAlc、LDL-C 水平明显高于5 年以上患者（P均<0.05)，而HDL-C 低于5 年以上患者（P<0.05)；（5 ）HbA1c≥ 11%组的FBG水平明显高于HbA1c≤ 8%及HbA1c＝8～11%组（P<0.01），而UA、FINS、FCP、 2hINS、2hCP 水平明显低于HbA1c<8%组（P 均<0.01)；FBG、TG 与HbA1c 水平呈正相关（P<0.05）；FINS、FCP、2hINS、2hCP、UA 与HbA1c 水平呈负相关（P<0.01)；结论：BMI、FBG、TG、LDL-C、BUN、UA、HDL-C、CREA均可作为T2DM诊断的参考指标。其中 LDL-C、BUN、CREA、2hINS 指受年龄影响。TG、CREA、UA、FCP(空腹C-肽）、2hCP与肥胖相关。FBG、TG、HbAlc、LDL-C、HDL-C 与病程相关；FBG、TG、HbA1c、FINS、FCP、2hINS、2hCP、UA与HbA1c 相关。

英文摘要:

Objective:To investigate the relationship among different body mass index (BMI), hemoglobinA1C (HbAlc), different courses of disease, related metabolic indicators in the diagnosis and prognosis of type 2 diabetic mellitus.Methods:379 type 2 diabetes patients and 383 normal healthy people were randomly divided into two groups. HbAlc was detected with high performance liquid chromatography in type 2 diabetic patients. The Roche COBAS-e601 electrochemical luminescence instrument was used to determine the levels of insulin and C-peptide. Measurement data were compared by using T-test, ANOVA and pearson correlation analysis, and chi-square test was used for the count data.Results:(1)The levels of BMI, FBG, TG, LDL-C, BUN, UA, HbA1c in the patients group were significantly higher than that in the normal group（P<0.01), and the levels of HDL-C and CREA were lower than that in normal group（P<0.01). (2)The level of TC, LDL-C, BUN, CREA and 2hINS were related with age. (3)The levels of TG, CREA, UA, FCP（fasting C peptide) and 2hCP in the obese group（BMI ≥ 25）were higher than that in non-obese group（BMI<25）(P<0.05). (4)The levels of FBG, TG, HbAlc and LDL-C in the newly diagnosed patients (<1 year) were significantly higher than those in the group with the course of disease beyond 5 years.(P<0.05), and HDL-C levels were lower than those in the group with the course of disease beyond 5 years（P<0.05). (5)The levels of FBG in the group with HbA1c≥ 11%was higher than that in the group with HbA1c≤ 8 and in the group with HbA1c8～11%（P<0.01）, and the levels of UA, FINS, FCP, 2hINS, 2hCP were significantly lower than that in the group with HbA1c<8%(P<0.01). Pearson correlation analysis shows that FBG and TG have positive correlation with HbAlc (P<0.05）, and FINS, FCP, 2hINS, 2hCP and UA showed a significant negative correlation with HbAlc (P<0.01).Conclusion:The levels of BMI, FBG, TG, LDL-C, BUN, UA, HDL-C, CREA could be regarded as the reference indicators for the diagnose, and LDL-C, BUN, CREA, 2hINS were influenced on age. TG, CREA, UA, FCP (fasting C-peptide) and 2hCP were related with obesity. The course of disease could change the levels of FBG, TG, HbAlc, LDL-C, HDL-C. Therefore, the levels of FBG, TG, HbA1c, FINS, FCP, 2hINS, 2hCP and UA were associated with HbA1c.

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