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目的探讨血糖控制水平对T2DM合并动脉粥样硬化(AS)患者血清铁蛋白(SF)、胰岛α、β细胞功能的影响。方法纳入233例T2DM合并AS患者,按HbA_1c水平分为6.0%≤HbA_1c<7.0%组、7.0%≤HbA_1c%8.0%组及HbA_1c≥8.0%组。检测各组SF和OGTT后0、30、60、120、180min PG、C-P、胰升血糖素(Glu)。结果 HbA_1c≥8.0%组各时间点C-P、PG均高于其他两组(P<0.05或P<0.01),Glu 0、30、60、120及180 min均高于其他两组(P<0.05或P%0.01);7.0%≤HbA_1c<8.0%组C-P、Glu 60、120及180 min均高于6.0%≤HbA1c<7.0%组(P<0.05或P<0.01),PG 30、60、120及180 min均高于6.0%≤HbA_1c<7.0%组(P<0.05);HbA_1C≥8.0%组AUC_(C-P)、AUC_(Glu)、AUC_(PG)高于其他两组(P<0.05),7.0%≤HbA_1c<8.0%组AUC_(C-P)、AUC_(Glu)高于6.0%≤HbA_1 c<7.0%组(P<0.05)。多元逐步回归分析显示,AUC_(C-P)BMI、SF、TS、AUC_(PG)、总铁结合力(TIBC)是AUC_(C-P)的影响因素;BMI、2 hPG、SF、SI、TS、AUC_(PG)、TIBC是AUC_(Glu)的影响因素。结论 T2DM合并AS患者SF过负荷不仅损伤胰岛β细胞,同时也影响胰岛α细胞分泌功能。
Objective To investigate the effects of glycemic control on serum ferritin (SF), islet α, β cell function in patients with T2DM complicated with atherosclerosis (AS). Methods A total of 233 T2DM patients with AS were enrolled. According to the level of HbA_1c, they were divided into 6.0% ≤HbA_1c <7.0%, 7.0% ≤HbA_1c% 8.0% and HbA_1c≥8.0%. The levels of PG, C-P and glucagon were detected at 0, 30, 60, 120 and 180 minutes after SF and OGTT in each group. Results The levels of CP and PG in HbA_1c≥8.0% group were significantly higher than those in the other two groups at each time point (P <0.05 or P <0.01). Glu levels at 0, 30, 60, 120 and 180 min were higher than those in the other two groups (P <0.01 or P <0.01), and the percentages of CP, Glu at 60, 120 and 180 min in 7.0% ≤HbA_1c <8.0% were higher than those in 6.0% ≤HbA1c <7.0% (P <0.05); AUC_ (CP), AUC_ (Glu) and AUC_ (PG) in HbA_1C≥8.0% group were higher than those in the other two groups (P <0.05) AUC_ (CP) and AUC_ (Glu) of% ≤HbA_1c <8.0% were higher than 6.0% ≤HbA_1 c <7.0% (P <0.05). The results of multivariate stepwise regression analysis showed that AUC_ (CP) BMI, SF, TS, AUC_ (PG) and TIBC were the influencing factors of AUC_ (CP) PG), TIBC is the influencing factor of AUC_ (Glu). Conclusion SF overload in T2DM patients with AS not only damages islet β cells, but also affect the secretion of pancreatic α cells.