严重的COVID-19相关高血糖症是由β细胞功能障碍引起的:一个前性队列研究
Jan Gojda1, Kateřina Koudelková2, Anna Ouřadová2
1Department of Internal Medicine, Third Faculty of Medicine, Charles University, and Královské Vinohrady University Hospital, Prague, Czech Republic. jan.gojda@lf3.cuni.cz.
Nutrition & diabetes
|July 17, 2023
概括
严重的COVID-19幸存者可能会因为β细胞功能障碍而患上高血糖症,而不是胰岛素抵抗. 这项对以前没有糖尿病的患者的研究发现胰岛素反应受损,而不是胰岛素敏感性,与感染后高血糖症有关.
科学领域:
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
- 代谢综合征是代谢综合征的一种.
背景情况:
- COVID-19 (由SARS-CoV-2引起) 与新发糖尿病有关.
- 导致COVID-19后高血糖的机制尚不清楚.
- 这项研究调查了胰岛素抵抗和β细胞功能障碍的作用.
研究的目的:
- 为了确定严重的COVID-19幸存者的高血糖是否与胰岛素抵抗或β细胞功能障碍有关.
- 在感染后六个月内分析代谢变化和葡萄糖调节.
主要方法:
- 检查了在基线,3个月和6个月之前没有糖尿病的严重COVID-19幸存者.
- 使用口服葡萄糖耐受性测试 (OGTT),间接热量计和皮质类固醇使用评估.
- 使用DI和ISI等指数测量胰岛素反应和敏感性;计算休息能量消耗 (REE).
主要成果:
- 在基线17名患者和6个月后13名患者中存在高血糖症.
- 在高血糖和正常血糖组中,胰岛素敏感性相似.
- 高血糖患者呈现较低的胰岛素反应 (DI),表明β细胞功能障碍.
结论:
- 严重的COVID-19最初会增加REE和胰岛素耐药性,但这些影响是暂时的.
- 这些患者的高血糖主要是由于β细胞功能障碍,而不是持续的胰岛素抵抗.
- 胰岛素反应不足是导致COVID-19后高血糖症的关键因素.
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