摘要
目的研究氧化应激所介导的胰岛素代谢紊乱在初诊酮症倾向2型糖尿病(KPD)中的作用。方法选取初诊KPD患者80例作为KPD组,初诊单纯T2DM患者80例作为T2DM组,统计两组临床资料,分析初诊KPD患者临床特征。检测两组氧化应激指标谷胱甘肽过氧化物酶(GSH-Px)、总超氧化物歧化酶(T-SOD)和丙二酮(MDA)水平,分析氧化应激与初诊KPD患者胰岛素代谢紊乱的相关性,明确氧化应激是否通过介导胰岛素代谢紊乱参与KPD的发生。结果与T2DM组比较,KPD组男性、多饮、多尿、体质量下降比例升高,FBG、2hPG、HbA1c水平升高,年龄、BMI、FCP、FINS、HOMA-IR、ISI、HOMA-β水平降低,病程缩短(P<0.05)。KPD组氧化应激指标MDA水平高于T2DM组,GSH-Px、T-SOD水平低于T2DM组(P<0.05)。Pearson分析显示,初诊KPD患者氧化应激指标GSH-Px、T-SOD与FINS、HOMA-IR、ISI、HOMA-β呈正相关(P<0.05),MDA与FINS、HOMA-IR、ISI、HOMA-β呈负相关(P<0.05)。非条件Logistic回归分析显示,男性、年龄、FBG、HbA1c、HOMA-IR、ISI、HOMA-β及氧化应激指标GSH-Px、T-SOD、MDA是初诊KPD发病的危险因素(P<0.05)。进一步分析氧化应激状态及胰岛素代谢在初诊KPD中的作用发现,初诊KPD患者酮症纠正治疗后氧化应激指标GSH-Px、T-SOD和胰岛素代谢指标FINS、HOMA-IR、ISI、HOMA-β水平高于纠正治疗前,MDA水平低于纠正治疗前(P<0.05)。ROC曲线显示,GSH-Px、T-SOD、MDA联合预测初诊KPD效能最优,AUC为0.904,灵敏度为90.50%、特异度为86.56%。结论初诊KPD患者中以男性多见、发病年龄更小、血糖更高、胰岛功能更差、氧化应激程度更强烈,氧化应激所介导的胰岛素代谢紊乱与初诊KPD发生有关。
Objective To study the role of oxidative stress mediated insulin metabolic disorder in newly diagnosed ketosis-prone type 2 diabetes(KPD).Methods Selected 80 patients with newly diagnosed KPD as the KPD group,and 80 patients with newly diagnosed simple T2DM as the T2DM group,clinical data of two groups were collected,and analyzed the clinical characteristics of newly diagnosed KPD patients.The oxidative stress indicators glutathione peroxidase(GSH-Px),total superoxide dismutase(T-SOD),and malondialdehyde(MDA)levels were detected in two groups,The correlation between oxidative stress and insulin metabolism disorders in newly diagnosed KPD patients,analyzed and clarified whether oxidative stress participates in the occurrence of KPD by mediating insulin metabolism disorders.Results Compared with the T2DM group,the proportion of male,polydipsia,polyuria,weight loss,FBG,2hPG,and HbA1c in the KPD group increased,while age,BMI,FCP,FINS,HOMAIR,ISI,and HOMA-βdecreased,and the disease course shortened(P<0.05).The MDA level of oxidative stress indicators in the KPD group was higher than that in the T2DM group,while the GSH-Px and T-SOD levels were lower than those in the T2DM group(P<0.05).Pearson analysis showed that oxidative stress indicators GSH-Px and T-SOD were positively correlated with FINS,HOMA-IR,ISI,and HOMA-β(P<0.05),while MDA was negatively correlated with FINS,HOMA-IR,ISI,and HOMA-β(P<0.05).Unconditional Logistic regression analysis showed that male,age,FBG,HbA1c,HOMA-IR,ISI,HOMA-β,and oxidative stress indicators GSH-Px,T-SOD,and MDA were risk factors for the onset of newly diagnosed KPD(P<0.05).Further analysis of the role of oxidative stress status and insulin metabolism in newly diagnosed KPD revealed that oxidative stress indicators GSH-Px,T-SOD,insulin metabolism indicators FINS,HOMA-IR,ISI,and HOMA-βwere higher after ketosis correction treatment than before correction treatment,and MDA level was lower than before correction treatment(P<0.05).The ROC curve showed that the combination efficacy of GSH-Px,T-SOD and MDA predicted KPD were the best,the AUC was 0.904,the prediction sensitivity was 90.50%,and the specificity was 86.56%.Conclusion Among the newly diagnosed KPD patients,males are more common,with younger onset age,higher blood glucose,worse islet function,and more intense oxidative stress.The insulin metabolism disorder mediated by oxidative stress is associated with occurrence of newly diagnosed KPD.
作者
黄海齐
Huang Haiqi(Endocrinology Department of Heze Traditional Chinese Medicine Hospital,Heze 274000)
出处
《中国现代医药杂志》
2025年第1期7-13,共7页
Modern Medicine Journal of China
关键词
2型糖尿病
酮症倾向
氧化应激
胰岛素代谢紊乱
Type 2 diabetes
Ketosis-prone
Oxidative stress
Insulin metabolism disorder
作者简介
通信作者:黄海齐,E-mail:huanghq8209@163.com。
