背景:2型糖尿病(T2DM)的发病机制与初始胰岛素抵抗(IR)和随后的β细胞功能障碍有关。胰岛素治疗可以替代晚期的β细胞功能。然而,过度的胰岛素治疗会增加IR,并可能使患者面临心血管疾病的风险。我们旨在通过空腹C肽与葡萄糖之比(FCPGR)评估胰岛素治疗2型糖尿病患者的β细胞功能和IR,和甘油三酯葡萄糖(TyG)指数分别支持治疗计划。
方法:在埃尔比勒市的Galiawa糖尿病和内分泌学教学中心进行了一项横断面研究,伊拉克,从2023年6月到2024年1月。在获得知情书面同意并排除急性疾病等条件后,纳入了100名接受胰岛素治疗的T2DM患者的方便样本。不确定类型的糖尿病,等。评估每位患者的人体测量参数和当前治疗细节。然后进行生化测试以计算代谢综合征(MetS)指数评分,FCPGR,和TyG指数。最后,根据FCPGR和TyG指数将患者分为4个亚组,并对数据进行统计学分析.
结果:数据显示,具有足够β细胞功能的患者为60(60%),TyG指数高的患者为95(95%)。FCPGR与血红蛋白A1c(HbA1c)呈显著负相关(p值=0.001),而TyG指数与HbA1C呈正相关(p值=0.001)。这些标记都不与BMI相关(p值=0.297和0.976),T2DM的持续时间(p值=0.258和0.458),和胰岛素治疗的剂量(p值=0.901和0.477)。具有足够β细胞功能和高TyG指数的患者HbA1C最低。
结论:该研究为FCPGR和TyG指数作为胰岛素治疗的T2DM患者β细胞功能和胰岛素抵抗的生物标志物的实用性提供了有价值的见解。与HbA1C的显着相关性强调了它们在临床实践中的潜力。然而,与BMI缺乏相关性,疾病持续时间,和胰岛素剂量表明,需要进一步的研究,以充分了解这些生物标志物在不同患者档案中的意义。
BACKGROUND: Pathogenesis of type 2 diabetes mellitus (T2DM) is combined from initial insulin resistance (IR) and subsequent β-cell dysfunction. Insulin therapy can replace β-cell function in advanced stages. However excessive insulin therapy increases IR and may expose the patients to risk of cardiovascular disease. We aim to assess β-cell function and IR in patients with type 2 diabetes on insulin therapy by fasting C-peptide to glucose ratio (FCPGR), and triglyceride glucose (TyG) index respectively to support treatment plans.
METHODS: A cross-sectional study was conducted at the Galiawa Diabetes and Endocrinology Teaching Center in Erbil City, Iraq, from June 2023 to January 2024. A convenient sample of 100 patients with T2DM on insulin-based therapy were included after obtaining informed written consent and excluding conditions such as acute illness, uncertain type of diabetes, etc. Each patient was evaluated for anthropometric parameters and current treatment details. Biochemical tests were then carried out to calculate metabolic syndrome (MetS) index score, FCPGR, and TyG index. Finally, patients were divided into four subgroups according to their FCPGR and TyG index and the data were analyzed statistically.
RESULTS: The data showed those patients with sufficient β-cell function were 60 (60%), and patients with high TyG index were 95 (95%). There was a significant negative correlation between FCPGR and hemoglobin A1c (HbA1c) (p-value=0.001), while there was a positive correlation between TyG index and HbA1C (p-value=0.001). None of these markers were correlated with BMI (p-value=0.297, and 0.976), duration of T2DM (p-value=0.258, and 0.458), and dose of insulin therapy (p-value=0.901, and 0.477). Patients with sufficient β-cell function and high TyG index had the lowest HbA1C.
CONCLUSIONS: The study provides valuable insights into the utility of FCPGR and TyG index as biomarkers for β-cell function and insulin resistance in T2DM patients on insulin therapy. The significant correlation with HbA1C underscores their potential in clinical practice. However, the lack of correlation with BMI, disease duration, and insulin dose suggests that further investigation is needed to fully understand these biomarkers\' implications across diverse patient profiles.