摘要
目的探讨A-β+型酮症倾向糖尿病(KPD)发生的危险因素。方法选取2014年1月—2015年6月于浙江医院住院的A-β+型KPD患者44例为病例组,另选择同期本院诊断为初发2型糖尿病(T2DM)且无自发酮症倾向患者64例为对照组。记录患者性别、年龄、体质指数(BMI)、T2DM家族史及高血压病史,检测随机血糖、动脉血气分析、血酮体、尿酮体、谷氨酸脱羧酶抗体(GAD-Ab)和酪氨酸磷酸酶抗体(IA-2Ab)。对照组于入院时,病例组于酮症纠正后次日检测空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、空腹C肽(F-CP)、餐后2 h C肽(2 h-CP)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、血尿酸(UA)水平。结果病例组FPG、Hb A1c、TC水平高于对照组,F-CP、2 h-CP水平及胰岛β细胞功能指数(HOMA2-%B)低于对照组,差异均有统计学意义(P<0.05)。单因素Logistic回归分析结果显示,Hb A1c、TC、HOMA2-%B是A-β+型KPD发生的影响因素(P<0.05)。经性别、年龄、BMI校正的多因素Logistic回归分析结果显示,低BMI〔OR=0.34,95%CI(0.15,0.80)〕、高TC〔OR=1.39,95%CI(1.21,1.66)〕、HOMA2-%B〔OR=0.17,95%CI(0.08,0.39)〕是A-β+型KPD发生的独立危险因素(P<0.05)。结论 A-β+型KPD是BMI、TC、HOMA2-%B等多因素共同作用的结果,需采取综合干预措施预防其发生。
Objective To investigate the risk factors for A - β ＋ type KPD. Methods We enrolled 44 patients with A - β ＋ type KPD who were admitted into Zhejiang Hospital from January 2014 to June 2015 as case group,and enrolled 64 patients who were diagnosed as newly onset T2DM but without spontaneous ketosis tendency in the same hospital and period as control group. Data of the subjects were collected,including gender,age,BMI,T2DM family history and hypertension. Random blood glucose,arterial blood gas analysis,blood ketones,urine ketones,GAD - Ab and IA-2Ab were tested. FPG, HbA1c ,F-CP,2 h-CP,TG,TC,LDL-C and UA were tested at admission in control group and the day after ketones turning negative in case group. Results Case group was higher than control group in the levels of FPG,HbA1c and TC,and was lower than control group in the levels of F-CP and 2 h-CP and HOMA2-% B（P 〈 0. 05）. The univariate Logistic regression analysis showed that HbA1c ,TC and HOMA2-% B were risk factors for A - β ＋ type KPD（P 〈 0. 05）. After adjustment of gender,age and BMI,the multivariable Logistic regression analysis showed that low BMI〔OR = 0. 34,95% CI（0. 15,0. 80）〕,high TC〔OR = 1. 39,95% CI（1. 21,1. 66）〕and low HOMA2-% B〔 OR = 0. 17,95% CI（0. 08,0. 39）〕were independent risk factors for A - β ＋ type KPD（P 〈 0. 05）. Conclusion A - β ＋ type KPD is caused by the combined effect of multifactors including BMI,TC and HOMA2-% B. Comprehensive intervention from many aspects is needed in order to prevent its occurrence.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第17期2006-2009,共4页
Chinese General Practice
关键词
糖尿病
酮病
人体质量指数
胆固醇
危险因素
Diabetes mellitus
Ketosis
Body mass index
Cholesterol
Risk factors
作者简介
通信作者：江缨，310013浙江省杭州市，浙江医院中美糖尿病中心；E-mail：jiangy1210@163．com
