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目的探讨初诊2型糖尿病(type 2diabetes mellitus,T2DM)伴腹型肥胖与胰高糖素样肽-1(glucagon-like peptide-1,GLP-1)水平的相关性。方法 102例初诊T2DM患者,根据腰围分为腹型肥胖组59例和非腹型肥胖组43例。测量2组患者身高、体质量、腰围,计算体质量指数,并检测空腹GLP-1、血糖、糖化血红蛋白、胰高血糖素、C肽、血脂水平及肝、肾功能等指标。结果非腹型肥胖组GLP-1水平[(4.22±1.44)pmol/L]高于腹型肥胖组[(2.74±0.94)pmol/L)],差异有统计学意义(P<0.05);GLP-1与腰围(r=-0.518,P=0.000)、体质量指数(r=-0.230,P=0.021)、血糖(r=-0.221,P=0.026)、糖化血红蛋白(r=-0.591,P=0.000)、总胆固醇(r=-0.632,P=0.000)呈负相关,与C肽呈正相关(r=0.244,P=0.013);logistic回归分析显示,腰围(β=-0.452,P=0.000)、总胆固醇(β=-0.311,P=0.001)、血糖(β=0.237,P=0.004)、糖化血红蛋白(β=-0.398,P=0.000)为GLP-1水平的独立影响因素。结论初诊T2DM伴腹型肥胖患者GLP-1水平明显低于非腹型肥胖T2DM患者,腰围、体质量指数、血糖、糖化血红蛋白、总胆固醇是影响GLP-1水平的因素。
Objective To investigate the relationship between type 2 diabetes mellitus (T2DM) and abdominal obesity and the level of glucagon-like peptide-1 (GLP-1) in patients with newly diagnosed type 2 diabetes mellitus. Methods A total of 102 newly diagnosed T2DM patients were divided into abdominal obesity group (n = 59) and non-abdominal obesity group (n = 43) according to waist circumference. Body height, body weight and waist circumference were measured in two groups. Body mass index (GLP-1), fasting glucose, glycosylated hemoglobin, glucagon, C-peptide, blood lipid and liver and kidney function were measured. Results The GLP-1 level in non-abdominal obesity group was significantly higher than that in abdominal obesity group (4.22 ± 1.44 pmol / L, 2.74 ± 0.94 pmol / L, P <0.05) (R = -0.230, P = 0.021), blood glucose (r = -0.221, P = 0.026), HbA1c (r = -0.518, P = 0.000) (P = 0.000), total cholesterol (r = -0.632, P = 0.000), and positive correlation with C peptide (r = 0.244, P = 0.013). Logistic regression analysis showed that waist circumference ), Total cholesterol (β = -0.311, P = 0.001), blood glucose (β = 0.237, P = 0.004) and glycosylated hemoglobin (β = -0.398, P = 0.000) were independent influencing factors of GLP-1 level. Conclusion The GLP-1 level in newly diagnosed T2DM patients with abdominal obesity is significantly lower than that in non-abdominal obese T2DM patients. The factors such as waist circumference, body mass index, blood glucose, glycosylated hemoglobin and total cholesterol are the factors influencing the level of GLP-1.