2型糖尿病患者强化治疗前后血清铁变化与胰岛素抵抗的关系

摘要

Objective To investigate the correlation between serum iron (SI) and insulin resistance (IR) in type 2 diabetic patients (T2DM) treated with short-term continuous subcutaneous insulin infusion (CSII).Methods A total of 330 patients with T2DM in endocrinology department were enrolled in this study.All the subjects were treated with CSII for about 1 week.SI,Fasting Plasma Glucose (FPG),and Fasting C-Peptide (FC-P) were recorded before and after glucose goal achievements.The FPG and FC-P were used to calculate IR by Homeostasis Model Assessment 2 (HOMA2).The determination range of FPG and FC-P were 3.0~25 mmol/L and 0.6~10.5 ng/ml respectively.Results FPG,SI and HOMA2-IR were all decreased after intensive treatment.Pearson correlation analysis showed that ΔIR was positively correlated with ΔSI(t=24.191,P<0.01),but not correlated with ΔHOMA2-β (P=0.505).Multiple linear regression analysis showed that HOMA2-IR,BMI,Reticulocyte hemoglobin content(Ret-He),duration of intensive treatment,age,HbA1c,and duration of disease were the independent factors for ΔSI.Conclusion SI and IR were decreased after short-term CSII therapy in T2DM.%目的 探讨短期胰岛素泵强化治疗的T2DM患者血清铁(SI)变化与IR的关系.方法 选取于我院内分泌科就诊的T2DM患者330例,行1周左右胰岛素泵治疗.记录血糖达标前、后时间段的SI、FPG和FC-P,将FPG、FC-P代入稳态模型公式2(HOMA2)计算IR.测定范围:FPG 3.0~25.0 mmol/L,FC-P 0.6~10.5 ng/ml.结果 强化治疗后FPG下降,SI、HOMA2-IR随之下降.Pearson相关分析显示,ΔSI与ΔHOMA2-IR呈正相关(t=24.191,P<0.01),与ΔHOMA2-β无相关性(P=0.505).多元线性回归分析显示,ΔHOMA2-IR、BMI、网织红细胞血红蛋白含量(Ret-He)、强化治疗时间、年龄、HbA1c、病程是ΔSI的独立影响因素.结论 T2DM患者经短期胰岛素泵强化治疗后SI下降,IR减少.