【摘要】目的 比较不同HbA1c水平的新诊断T2DM患者血糖、胰岛素敏感性与胰岛素分泌功能、慢性并发症等情况。方法 选取新诊断T2DM患者210例，根据HbA1c水平分为3组，用HOMA-IR、QUICKI、OGIS评估胰岛素敏感性，HOMA-β、AUCIns及AUCR评估胰岛素分泌功能。对HbA1c的影响因素进行逐步多元回归分析。经多个独立样本非参数检验比较各组慢性并发症发生率。结果 组间比较显示，随着HbA1c的升高，各时点血糖均明显升高，空腹及餐后2 hIns水平明显下降。OGIS、HOMA-β、AUCins及AUCR均显著下降(P<0.01)。HbA1c与2 hPG呈显著正相关(r=0.675，P<0.01)，与HOMA-β、OGIS呈显著负相关(r=-0.632，-0.578，P<0.01)。各组慢性并发症发生率均较高，但差异无统计学意义。结论 新诊断T2DM患者已处在高HbA1c水平，胰岛素敏感性下降显著，胰岛分泌功能已明显受损。慢性并发症发生率高。

　　【关键词】糖尿病，2型;糖化血红蛋白;胰岛素敏感性;胰岛素分泌

　　Observation on insulin sensitivity and insulin secretion in newly diagnosed T2DM under the condition of glucose toxicity  PAN Xiao-jie, ZHU Qi-qian. Department of Endocrinology, Shaoxing People’s Hospital, Shaoxing 312000, China

　　Corresponding author: ZHU Qi-qian, Email: sxzqq@126.com

　　【Abstract】Objective To compare the blood glucose, insulin sensitivity, insulin secretion and chronic complications with different HbA1c levels in newly diagnosed T2DM patients. Methods A total of 210 newly diagnosed T2DM patients were divided into three groups according to their HbA1c levels. The insulin sensitivity of the patients was assayed by HOMA-IR, QUICKI, and OGIS. The insulin secretion was discussed with HOMA-β, AUCIns, and AUCR, while the influencing factors of HbA1c were analyzed by stepwise multiple regression analysis, and the incidence of the chronic complications was compared through the non-parameter tests of multiple independent samples. Results The between-group comparison showed that with the HbA1c elevation, the blood glucose of each time point was significantly increased, but the fasting and 2hIns were decreased significantly, and the OGIS, HOMA-β, AUCins, and AUCR were all decreased significantly (P<0.01). HbA1c was significantly positively correlated with 2hPG (r=0.675, P<0.01), and significantly negatively correlated with HOMA-β and OGIS (r=-0.632, -0.578, P<0.01). The incidence of chronic complications in each group was high, but without significant difference among groups. Conclusion The newly diagnosed T2DM patients are in the state of high level of HbA1c already, their insulin sensitivity and insulin secretion are decreased significantly, and the incidence of chronic complications is high.

　　【Key words】Diabetes mellitus, type 2; Glycosylated hemoglobin (HbA1c); Insulin sensitivity; Insulin secretion