摘要
目的:探讨补硒对早发初诊2型糖尿病(EOT2DM)低硒患者的胰岛素抵抗和Hs-CRP的影响。方法:选取2019年1月~12月期间在湖南师范大学附属湘东医院内分泌科门诊或住院的128例患者,EOT2DM组72例,EOT2DM组又分EOT2DM-1组和EOT2DM-2组两亚组,56例晚发2型糖尿病作为LOT2DM组,同期52例体检中心健康人为健康对照组,共180例;检测三组Se、Hs-CRP等生化指标,计算HOMA-IR;分析Se、Hs-CRP与HOMA-IR等指标的相关性;绘制Se在EOT2DM组、LOT2DM组两组人群的ROC曲线计算曲线下面积(AUC);EOT2DM-1组和EOT2DM-2组治疗前后Se、Hs-CRP及HOMA-IR的比较。结果:与健康对照组比较,EOT2DM组、LOT2DM组血清Se水平下降、Hs-CRP水平升高;与LOT2DM组比较,EOT2DM组Se下降、Hs-CRP升高、糖尿病家族史及超重或肥胖发生率升高;Se与Hs-CRP、HOMA-IR呈负相关,Hs-CRP与HOMA-IR呈正相关;以Se为检验变量,EOT2DM、LOT2DM为状态变量,绘制Se的ROC曲线曲线下面积(AUC)比:0.907vs0.657;EOT2DM-1组和EOT2DM-2组治疗后与治疗前相比Hs-CRP、HOMA-IR、FPG、HbA1c、血脂均降低,且降低幅度EOT2DM-1组高于EOT2DM-2组;与治疗前对比,EOT2DM-1组血清硒升高。结论:EOT2DM患者有更显著的家族性倾向及更高的超重或肥胖发生率;2型糖尿病患者Se水平低,EOT2DM患者尤甚,且补硒有助于减轻EOT2DM患者胰岛素抵抗,增强抗氧化应激能力,改善糖脂代谢紊乱;低硒可推荐作为预测EOT2DM发病风险因子。
Objective To determine the effect of selenium supplementation on insulin resistance and Hs-CRP in early-onset type 2 diabetes mellitus(EOT2DM)patients with low selenium.Methods Select 128 patients who were in the outpatient or inpatient department of the Endocrinology Department of Xiangdong Hospital Affiliated to Hunan Normal University from January to December 2019.Among them,72 cases of EOT2DM were in group EOT2DM,and group EOT2DM was divided into EOT2DM-1(selenium supplement group)and In the two subgroups of EOT2DM-2,56 cases of late-onset type 2 diabetes mellitus were classified as group LOT2DM,and 52 cases of healthy people in the physical examination center were classified as group Control during the same period,with a total of 180 cases;Detection of three groups of Se and Hs-CRP and other biochemical indicators,calculate HOMA-IR;Analyze the correlation between Se,Hs-CRP and HOMA-IR;Draw the ROC curve of Se in the A and B groups to calculate the area under the curve(AUC);Se,Hs-CRP and HOMA-IR were compared in EOT2DM-1 and EOT2DM-2 groups before and after treatment.Results Compared with Control,serum selenium level decreased and Hs-CRP level increased in group EOT2DM-1 and LOT2DM,compared with group LOT2DM,Se level decreased,Hs-CRP level increased,family history of diabetes,and overweight or obesity in group EOT2DM-1 the incidence increased,and the difference was statistically significant;Se was negatively correlated with Hs-CRP and HOMA-IR,and Hs-CRP was positively correlated with HOMA-IR;With Se as the test variable,EOT2DM and LOT2DM as the state variables,plot the area under the ROC curve(AUC)ratio of Se:0.907 vs 0.657;Treatment in groups EOT2DM-1 and EOT2DM-2.Compared with before treatment,Hs-CRP,HOMA-IR,FPG,FINS,HbA1c,TG,TC,LDL-C were all reduced,and the reduction range was EOT2DM-1>EOT2DM-2;Compared with before treatment,serum selenium increased in group EOT2DM-1,and the difference was statistically significant.Conclusion EOT2DM patients have more significant familiar tendency and higher incidence of overweight or obesity;Se levels is low in patients with type 2 diabetes,especially in patients with EOT2DM and selenium supplementation helps reduce insulin resistance,enhance antioxidant stress ability,and improve glucose and lipid metabolism disorders;Low selenium can be recommended as a risk factor of EOT2DM.
作者
曹卫娟
李青
李星雨
周国艳
Cao Wei-juan;Li Qing;Li Xing-yu;Zhou Guo-yan(Department of Endocrinology,Xiangdong Hospital of Hunan Normal University,Liling 412200,China)
出处
《湖南师范大学学报（医学版）》
2021年第6期13-17,共5页
Journal of Hunan Normal University(Medical Sciences)
基金
湖南省教育厅(18C0032)
作者简介
通讯作者:李青,E-mail:1402598379@qq.com
