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目的探讨2型糖尿病(T2DM)患者的胰岛B细胞分泌功能及胰岛素敏感性与内生肌酐清除率(Ccr)的相关性。方法随机抽取住院患者195例,肾功能正常组45例(A组)、肾小球高滤过组45例(B组)、肾功能轻度下降组50例(C组)及肾功能中重度下降组55例(D组)。计算血肌酐(SCr),胰岛素C肽释放试验、胰岛素曲线下面积(AUCI)和葡萄糖曲线下面积(AUCG)。结果与A组相比,C组、D组胰岛素抵抗指数(HOMA-IR)明显升高,胰岛素敏感指数ISI、Matsuda ISI明显下降,差异具有统计学意义(P<0.05);D组AUCI/AUCG明显高于其他三组,差异具有统计学意义(P<0.05)。结论在2型糖尿病中,Ccr与胰岛素抵抗呈负相关,随着Ccr的下降,胰岛素抵抗逐渐加重,胰岛素抵抗可能是肾功能下降的独立危险因素。
Objective To investigate the relationship between pancreatic B cell secretory function and insulin sensitivity and endogenous creatinine clearance (Ccr) in type 2 diabetes mellitus (T2DM). Methods A total of 195 hospitalized patients, 45 patients with normal renal function (group A), 45 patients with glomerular hyperfiltration (group B), 50 patients with mild renal dysfunction (group C) and moderate to severe renal function Descending group of 55 patients (D group). Serum creatinine (SCr), insulin C peptide release test, area under the curve of insulin (AUCI) and area under the curve of glucose (AUCG) were calculated. Results Compared with group A, the insulin resistance index (HOMA-IR) of group C and group D were significantly increased, but the ISI and Matsuda ISI of insulin group were significantly decreased (P <0.05). The AUCI / AUCG Significantly higher than the other three groups, the difference was statistically significant (P <0.05). Conclusions In type 2 diabetes, Ccr is negatively correlated with insulin resistance. With the decrease of Ccr, insulin resistance gradually aggravates. Insulin resistance may be an independent risk factor for the decline of renal function.