發(fā)布時間：2018-02-05 21:31

  本文關鍵詞： 酮癥傾向2型糖尿病 新診斷 胰島素抵抗　出處：《新疆醫(yī)科大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的探討新診斷酮癥傾向2型糖尿病(KPD)患者的臨床特征并分析其胰島素抵抗程度。方法收集新診斷的2型糖尿病(T2DM)患者327例,其中KPD者211例,無酮癥的T2DM者116例,比較并分析兩組臨床特點及胰島素抵抗相關指標。結果1.KPD組患者體質指數(shù)(BMI)(26.77±0.30kg·m-2)高于T2DM組(26.33±0.63kg·m=2),腰臀比(0.94±0.01)高于T2DM組(0.92±0.01),空腹血糖(FPG)(10.52±0.29mmol·L-1)高于T2DM組(9.01±0.52mmol·L-1),甘油三酯(TG)(3.84±0.29mmol·L-1)高于T2DM組(2.01±0.30mmol·L-1),胰島素抵抗指數(shù)(HOMA-IR)(5.81±1.22)低于T2DM組(6.94+1.95),合并脂肪肝者率KPD組(69.3%)低于T2DM組(72.40%),合并頸動脈粥樣硬化率KPD組(42.6%)低于T2DM組(44.8%),但上述差異均無統(tǒng)計學意義(P0.05)。2.KPD組患者平均發(fā)病年齡(38.44±0.65歲)低于T2DM組(44.72±1.24歲),診斷時平均糖化血紅蛋白KPD組(11.54%±0.17%)高于T2DM組(8.46%±0.31%),男性患者比例KPD組(86.7%)高于T2DM組(58.6%),餐后2小時血糖(2hPPG)KPD組(18.94±0.32mmol·L-1)高于T2DM組(17.15±0.65mmol·L-1),總膽固醇(TC)水平KPD組(4.88± 0.12mmol·L-1)高于T2DM組(4.18±0.22mmol·L-1),上述差異均有統(tǒng)計學意義(均P0.05)。3.年齡在20-40歲之間,KPD組較T2DM組有更高的HbAlC、由TG和IFP G計算所得簡易指數(shù)(TyG)、由TG和2hPPG計算所得簡易指數(shù)(TyG2)和TG/HDL-c比值(均P0.05),而其它年齡段,差異無統(tǒng)計學意義。4.根據(jù)性別劃分,男性KPD組較T2DM組存在更高的餐后2小時胰島素(2hPINS)、TC、TyG2、TG/HDL-c及糖尿病周圍神經病變患病率,(均P0.05)；女性：KPD組較T2DM組存在更高的HbAlC、糖尿病周圍神經病變患病率,(均P0.05)。結論1.在新診斷的T2DM患者中,KPD者較非酮癥T2DM患者發(fā)病早、血糖水平更高、血脂紊亂更明顯,并且男性KPD者較非酮癥T2DM患者存在更嚴重的胰島素抵抗,但女性患者的胰島素抵抗無明顯差異。2.在新診斷的T2DM青壯年(20-40歲)患者中,酮癥傾向患者較非酮癥患者存在更嚴重的胰島素抵抗,在其他年齡段未見上述差異。
[Abstract]:Objective to investigate the clinical features and insulin resistance of newly diagnosed type 2 diabetes mellitus (KPD). Methods 327 newly diagnosed patients with type 2 diabetes mellitus (T2DM) were collected. There were 211 cases of KPD and 116 cases of T2DM without ketosis. Results 1. Body mass index (BMI) of KPD patients was 26.77 鹵0.30kg 路m ~ (-2) higher than that of T2DM group (P < 0.05). 26.33 鹵0.63 kg 路mm2). WHR (0.94 鹵0.01) was higher than that in T2DM (0.92 鹵0.01). The fasting blood glucose level was 10.52 鹵0.29 mmol 路L ~ (-1) in FPG group and 9.01 鹵0.52 mmol 路L ~ (-1) in T2DM group. Triglyceride triglyceride (TGG) was 3.84 鹵0.29 mmol 路L ~ (-1) higher than that of T2DM (2.01 鹵0.30 mmol 路L ~ (-1)). The insulin resistance index (HOMA-IRI) was 5.81 鹵1.22, lower than that in T2DM group (6.94 1.95). The rate of fatty liver in KPD group (69.3%) was lower than that in T2DM group (72.40%), and the rate of carotid atherosclerosis in KPD group (42.6%) was lower than that in T2DM group (44.8%). However, there was no significant difference in the mean age of onset between the KPD group (38.44 鹵0.65 years) and the T2DM group (44.72 鹵1.24 years). The mean value of glycosylated hemoglobin in KPD group (11.54% 鹵0.17%) was higher than that in T2DM group (8.46% 鹵0.31%). The proportion of male patients in KPD group (86.7%) was higher than that in T2DM group (58.6%). 2 h postprandial blood glucose was 18.94 鹵0.32 mmol 路L -1 in KPD group and 17.15 鹵0.65 mmol 路L -1 in T2DM group. The level of TC in KPD group was higher than that in T2DM group (4.88 鹵0.12 mmol 路L ~ (-1) vs 4.18 鹵0.22 mmol 路L ~ (-1)). All the above differences were statistically significant (P0.05. 3). The HbAlC was higher in KPD group aged 20-40 years than in T2DM group. The simple index was calculated by TG and IFP G, the simple index was calculated by TG and 2hPPG, and the ratio of TG/HDL-c (both P0.05) was calculated by TG and PPG. However, there was no significant difference in other age groups. 4. According to sex, there was a higher level of 2 hour postprandial insulin in male KPD group than in T2DM group. The prevalence of TG/HDL-c and diabetic peripheral neuropathy (P 0.05); The prevalence of diabetic peripheral neuropathy in female KPD group was higher than that in T2DM group (all P 0.05). Conclusion 1. In newly diagnosed T2DM patients. 2. The onset of KPD was earlier than that of non-ketotic T2DM patients, the level of blood glucose was higher, the disorder of blood lipid was more obvious, and the male patients with KPD had more severe insulin resistance than those with non-ketotic T2DM. However, there is no significant difference in insulin resistance in female patients. 2. In newly diagnosed T2DM patients aged 20-40 years, ketosis-prone patients have more severe insulin resistance than non-ketotic patients. These differences were not found in other age groups.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R587.1
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本文編號：1492818