摘要
目的探讨胰岛素抗体阳性2型糖尿病（T2DM）患者血清胆红素水平变化。方法收集住院T2DM的患者，共726例，按是否应用重组人胰岛素治疗，将糖尿病患者分为胰岛素治疗组和非胰岛素治疗组；将应用重组人胰岛素治疗的T2DM患者按胰岛素抗体阳性或阴性分为胰岛素抗体阳性组与胰岛素抗体阴性组，随机选择84名健康查体者作为正常对照组。分别分析上述各组与正常对照组之间血清胆红素水平的差异。结果血清总胆红素（TBIL）及间接胆红素（IBIL）在胰岛素治疗组、非胰岛素治疗组、正常对照组之间及胰岛素抗体阳性组、胰岛素抗体阴性组、正常对照组之间均有显著性差异（P〈0．05），胰岛素治疗组与非胰岛素治疗组比较二者无显著性差异（P〉0．05），胰岛素抗体阳性组TBIL、IBIL显著低于胰岛素抗体阴性组（P〈0．05）；Logistic回归分析提示低TBIL（OR=0．946，95％CI：0．901-0．994，P=0．028）、低IBIL（OR=0．931，95％C1：0．876～0．988，P=0.019）是胰岛素抗体阳性的危险因素；与无胰岛素抵抗患者比较，胰岛素抵抗患者血清TBIL、DBIL、IBIL几均明显降低（均P〈0．01）；胰岛素抵抗患者INS．Ab阳性率显著高于无胰岛素抵抗患者（P=0．000）。结论胰岛素抗体阳性T2DM患者血清TBIL、IBIL水平较低；T2DM患者低血清TBIL、IBIL水平是胰岛素抗体阳性及胰岛素抵抗的危险因素。
Objective To study the relationship between insulin antibody （INS-Ab） and the changes of serum bilirubin levels in patients with type 2 diabetes mellitus. Methods 726 cases of hospitalized patients with type 2 diabetes mellitus （T2DM） were divided into insulin-treated group and non-insulin-treated group, and patients treated with recombinant human insulin were divided into two groups, INS-Ab positive group and INS-Ab negative group. At the same time, 84 healthy subjects in examination centers were randomly selected as controls. Then, the differences of serum bilirubin levels between these groups and the control group were analysed. Results The differences of TBIL and IBIL levels between insulin-treated group, non-insulin-treated group, the control group and that between INS-Ab positive group, INS-Ab positive group, the control group were significant （P〈0.05）. There were no significant differences of TBIL and IBIL between insulin-treated group and non-insulin-treated group （P〉0.05）, while, TBIL and IBIL levels of INS-Ab positive group were significantly lower than that of INS-Ab negative group （P〈0.05）; Logistic regression analysis showed that decreased TBIL （0R=0.946, 95% CI： 0.901-0.994,P=0.028） and decreased IBIL （0R=0.931, 95% CI： 0.876-0.988, P=0.019） are the risk factors of INS-Ab. TBIL, DBIL and IBIL of patients with insulin resistance were significantly lower than that of patients without insulin resistance （P〈0.01）. The INS-Ab positive rate of them washigher than that of patients without insulin resistance, and the difference was significant （P=0.000）. Conclusion Comparing with patients in INS-Ab negative group and the control group, the serum TBIL and IBIL levels are lowest in INS-Ab positive patients with T2DM. Decreased TBIL and decreased IBIL are the risk factors of INS-Ab and insulin resistance in patients with T2DM.
出处
《中华临床医师杂志（电子版）》
CAS
2015年第3期43-47,共5页
Chinese Journal of Clinicians(Electronic Edition)
关键词
胰岛素抗体
糖尿病
2型
胆红素
Insulin antibodies
Diabetes mellitus, type 2
Bilirubin
