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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。
Objective: To study the relationship between BMI, HbA1c, course of disease, related metabolic indices and the diagnosis and prognosis of type 2 diabetes mellitus (T2DM). Methods: A total of 379 T2DM patients and 383 healthy volunteers were enrolled in this study. The biochemical indexes of the two groups were analyzed by biochemical analyzer. The levels of HbA1c in T2DM group were detected by high performance liquid chromatography (HPLC). The levels of insulin and C-peptide were detected by electrochemiluminescence. Measurement data using t test, single factor analysis of variance and correlation, count data using chi-square test analysis. Results: The results of each group showed that: (1) The levels of BMI, FBG, TG, LDL-C, BUN, UA and HbA1c in T2DM patients were significantly higher than those in normal controls (all P <0.01) (P <0.01). (2) The levels of TC, LDL-C, BUN, CREA and 2hINS were related to age. (3) The levels of TG, CREA, UA, FCP and 2hCP in obese group were higher than those in non-obese group (all P <0.05). (4) The levels of FBG, TG, HbAlc and LDL-C in newly diagnosed T2DM patients were significantly higher than those of 5 years (P <0.05). (5) The level of FBG in HbA1c≥11% group was significantly higher than that in HbA1c≤8% and HbA1c = 8 ~ 11% group (all P <0.05) (P <0.01), while the levels of UA, FINS, FCP, 2hINS and 2hCP in HbA1c group were significantly lower than those in HbA1c group (P <0.01); FBG, TG and HbA1c levels were positively correlated (P <0.01). Conclusions: BMI, FBG, TG, LDL-C, BUN, UA, HDL-C and CREA can all be used as reference indexes for the diagnosis of T2DM. Which LDL-C, BUN, CREA, 2hINS refers to the age-dependent. TG, CREA, UA, FCP (fasting C-peptide), 2hCP associated with obesity. FBG, TG, HbAlc, LDL-C and HDL-C were related to the course of the disease; FBG, TG, HbA1c, FINS, FCP, 2hINS, 2hCP, UA were associated with HbA1c.