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目的探讨2型糖尿病(Type 2diabetes mellitus,T2DM)患者残余β细胞功能与代谢控制及慢性并发症之间的关系。方法选取2015年5月-2016年5月在新疆某三甲医院就诊并确诊为T2DM的患者714例,其中男性407例,女性307例,根据血清空腹C-肽的三分位数由低到高分为C-P1组(<1.73ng/mL)、C-P2组(1.73~3.52ng/mL)和C-P3组(≥3.53ng/mL),比较3组一般资料、生理生化指标及相关并发症的发病情况,并分析血清C-肽水平与各代谢指标的相关性。结果 C-P1组T2DM诊断年龄、体质指数(Body Mass Index,BMI)、收缩压、舒张压、甘油三酯(Triacylglyceride,TG)水平显著低于C-P3组(P<0.05),而T2DM病程、糖化血红蛋白(HbAIc)、HDL-C水平及糖尿病视网膜病变的发病率显著高于C-P3组(P<0.05),而冠状动脉疾病、代谢综合征、脂肪肝发病率显著低于C-P3组(P<0.05)。在调整了相关因素后,血清空腹C-肽是糖尿病视网膜病变发生的保护因素,是冠状动脉疾病、代谢综合征、脂肪肝发生的危险因素。结论高水平的C-肽有利于控制血糖,降低糖尿病视网膜病变的发病率,而增加糖尿病冠状动脉疾病、代谢综合征和脂肪肝的发病率。
Objective To investigate the relationship between residual β-cell function and metabolic control and chronic complications in type 2 diabetes mellitus (T2DM). Methods From July 2015 to May 2016, 714 patients with T2DM diagnosed in a top three hospital in Xinjiang, including 407 males and 307 females, were selected according to the tertile of serum fasting C-peptide from low to high The patients were divided into C-P1 group (<1.73ng / mL), C-P2 group (1.73 ~ 3.52ng / mL) and C-P3 group (≥3.53ng / mL) The incidence of complications, and analysis of serum C-peptide levels and the relevance of various metabolic indicators. Results The age, body mass index (BMI), systolic blood pressure, diastolic blood pressure and triacylglyceride (TG) of T2DM in C-P1 group were significantly lower than those in C-P3 group (P <0.05) , HbAIc, HDL-C and diabetic retinopathy were significantly higher than those in C-P3 group (P <0.05), while the incidence of coronary artery disease, metabolic syndrome and fatty liver was significantly lower than that of C-P3 Group (P <0.05). After adjusting for related factors, serum fasting C-peptide is a protective factor of diabetic retinopathy, and is a risk factor of coronary artery disease, metabolic syndrome and fatty liver. Conclusions High levels of C-peptide are good for controlling blood glucose, reducing the incidence of diabetic retinopathy and increasing the incidence of diabetic coronary artery disease, metabolic syndrome and fatty liver.