[摘要] 目的 探讨C肽在围绝经期2型糖尿病合并代谢综合征患者中的变化及临床意义。 方法 选取2014年5月~2016年12月在承德医学院附属医院内分泌科住院的208例围绝经期2型糖尿患者为研究对象,分为合并代谢综合征(T2DM+MS)组111例和不合并代谢综合征(T2DM)组97例,分别检测空腹C肽、餐后2 h C肽、糖化血红蛋白(HbA1c)等指标。 结果 与不合并代谢综合征组比较,合并代谢综合征组空腹C肽[(0.86±0.08) vs (1.10±0.09)]和餐后2 h C肽[(1.09±0.02) vs (1.39±0.10)]均明显升高,差异有统计学意义(P /6/view-10121883.htm
[关键词] C肽;2型糖尿病;围绝经期;代谢综合征
[中图分类号] R587.1 [文献标识码] B [文章编号] 1673-9701(2018)06-0009-03
[Abstract] Objective To investigate the changes and clinical significance of C-peptide in patients with type 2 diabetes and metabolic syndrome during perimenopause. Methods A total of 208 cases with type 2 diabetes during perimenopausal period from May 2014 to December 2016 were treated in department of endocrinology of affiliated hospital of Chengde Medical College were enrolled in this study. They were divided into two groups: 111 patients with metabolic syndrome(T2DM+MS) group (n=111) and 97 patients without metabolic syndrome (T2DM) group (n=97). C-peptide, postprandial 2 h C-peptide(2 h PG), glycosylated hemoglobin(HbA1c) and other indicators were measured. Results Compared with those without metabolic syndrome, the C-peptide[(0.86±0.08) vs (1.10±0.09)] and postprandial 2 h peptide[(1.09±0.02) vs (1.39±0.10)] were significantly increased in patients with metabolic syndrome, and the difference was statistically significant(P 1.2 观察指标
清晨采集空腹静脉血,使用Beckman全自动生化分析仪检测空腹血糖(FBG)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、肝肾功能,高效液相色谱法检测糖化血红蛋白(HbA1c)。应用血常规检测仪检测血常规。所有患者均在血糖控制基本稳定后进行馒头餐试验,采用放射免疫法检测空腹和餐后2 h C肽。测量身高、体重,计算体重指数(BMI):BMI=体重(kg)/身高2(m2)。检测血压:坐位血压,两次测量间隔5 min,取平均值。
1.3 统计学方法
采用SPSS 19.0软件进行统计学分析,各组数据均进行正态性检验,符合正态分布的计量资料以(x±s)表示,非正态分布变量经自然对数转换成近似正态分布后进行分析,组间比较采用独立样本t检验;采用Pearson相关分析空腹C肽与临床指标的相关性。代谢综合征的影响因素行Logistic多元回归分析,P0.05)。T2DM+MS组患者的BMI、空腹C肽、餐后2 h C肽、TC、LDL-C、WBC计数、SBP、DBP及糖尿病病程明显高于T2DM组,HDL-C明显低于T2DM组(P参考文献]
[1] Mottillo S,Filion KB,Genest J,et al. The metabolic syndrome and cardiovascular risk. A systematic review and meta-analysis[J]. J Am Coll Cardiol,2010,56(14):1113-1132. [2] Wahren J,Larsson C. C-peptide:New findings and therapeutic possibilities[J]. Diabetes Res Clin Pract,2015,107(3):309-319.
[3] Abdulnour J,Doucet E,Brochu M,et al. The effect of the menopausal transition on body composition and cardiometabolic risk factors:A montreal ottawa new emerging Team group study[J]. Menopause,2012,19(7):760-767.
[4] Stachowiak G,Pertynski T,Pertynska-Marczewska M. Metabolic disorders in menopause[J]. Prz Menopauzalny,2015,14(1):59-64.
[5] Salminen M,Kuoppamaki M,Vahlberg T,et al. Metabolic syndrome and vascular risk:A 9-year follow-up among the aged in Finland[J]. Acta Diabetol,2011,48(2):157-165.
[6] ?利红.2型糖尿病患者胰腺体积与血清C肽水平的关系[J].中华胰腺病杂志,2017,17(1):52-54.
[7] Kressel G,Trunz B,Bub A,et al. Systemic and vascular markers of inflammation in relation to metabolic syndrome and insulin resistance in adults with elevated atherosclerosis risk[J]. Atherosclerosis,2009,202(1):263-271 .
[8] Abdullah A,Hasan H,Raigangar V,et al. C-peptide versus insulin:Relationships with risk biomarkers of cardiovascular disease in metabolic syndrome in young Arab females[J]. Int J Endocrinol,2012,(2012):420-792.
[9] 潘斌斌,苏晓飞,马建华,等.血清C肽与2型糖尿病患者血糖控制及并发症的关系分析[J].中华内分泌代谢杂志,2013,29(5):380-382.
[10] 林思彤,王丽强,刘龙,等.血清C肽水平与2型糖尿病患者血脂控制及心脑血管并发症关系研究[J].中国实验诊断学,2015,19(2):281-283.
[11] Antonio,José Gregorio,Itahisa,et al. C-peptide as a risk factor of coronary artery disease in the general population[J].Diab Vasc Dis Res,2015,12(3):199-207.
[12] Stachowiak G,Pertynski T,Pertynska-Marczewska M. Metabolic disorders in menopause[J]. Prz Menopauzalny,2015,14(1):59-64.
[13] Patel TP,Rawal K,Bagchi A K,et al. Insulin resistance:An additional risk factor in the pathogenesis of cardiovascular disease in type 2 diabetes[J]. Heart Failure Reviews,2016,21(1):11-23.
[14] Luppi P,Geng X,Cifarelli V,et al. C-peptide is internalised in human endothelial and vascular smooth muscle cells via early endosomes[J]. Diabetologia,2009,52(10):2218-2228.
[15] 刘萍萍,肖政辉,卢秀兰,等.重症患儿低C肽水平变化及其临床意义[J].中国急救医学,2015,35(3):262-266.
(收稿日期:2017-11-23)