基于HOMA2指数的β细胞功能和胰岛素敏感性的2型糖尿病亚组中的多神经病发病率
Frederik Pagh Bredahl Kristensen1, Diana Hedevang Christensen1,2, Brian Christopher Callaghan3
1Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
Diabetes care
|June 19, 2023
概括
通过高β细胞功能 (HOMA2-B) 表示的胰岛素过高,增加了2型糖尿病患者糖尿病多神经病 (DPN) 的风险,独立于代谢综合征. 这突显了高胰岛素血症是DPN预防策略的关键因素.
科学领域:
- 内分泌学 在内分泌学.
- 糖尿病学 糖尿病学
- 神经学 神经学
背景情况:
- 糖尿病多神经病变 (DPN) 是2型糖尿病 (T2DM) 的常见并发症.
- 代谢综合征成分和胰岛素抵抗是已知的DPN风险因素.
- 高胰岛素血症在DPN发展中的特定作用需要进一步研究.
研究的目的:
- 通过β细胞功能和胰岛素敏感性定义的T2DM亚组中调查DPN的流行率.
- 确定高胰岛素血症是否是DPN的独立风险因素.
主要方法:
- 在4388名新诊断T2DM患者中估计的β细胞功能 (HOMA2-B) 和胰岛素敏感性 (HOMA2-S).
- 将患者分类为高胰岛素性,古典性和胰岛素缺失的亚组.
- 使用密歇根神经病查仪问卷 (MNSIq) 评估DPN,平均随访3年后.
- 使用波桑回归和分线模型进行统计分析.
主要成果:
- 在高胰岛素血症患者中,DPN的患病率为23%,在古典性患者中为16%,在胰岛素缺乏T2DM患者中为14%.
- 超胰岛素血症患者在调整了混因素后,与经典患者相比,DPN的风险增加了1.35倍.
- 较高的HOMA2-B与增加的DPN患病率呈现线性关联,独立于代谢综合征和HOMA2-S.
结论:
- 超胰岛素血症,以高HOMA2-B为特征,是T2DM中DPN的重要危险因素.
- 即使考虑到代谢综合征成分和胰岛素抵抗,这种风险也存在.
- 针对高胰岛素血症可能对开发有效的DPN预防策略至关重要.
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