【摘要】 目的 观察新诊断T2DM患者胰岛β细胞功能的变化，并分析其相关因素，为T2DM的临床处理提供参考。 方法 对414例新诊断T2DM患者及143名正常糖耐量(NGT)人群行75 g OGTT和胰岛素释放试验，分别按照FPG、2 hPG、HbA1c和BMI进行分组，稳态模型评估胰岛β细胞功能指数(HOMA-β)、糖负荷后30 min净增胰岛素/净增血糖的比值(△I30/△G30)和胰岛素曲线下面积(AUCI)。 结果 T2DM各亚组FIns随FPG、2 hPG、HbA1c升高而升高，当FPG> 10.0 mmol/L、2 hPG >14.0 mmol/L、HbA1c >9%时，FIns开始下降;BMI≥25 kg/m2亚组FIns(11.29±4.83)μIU/ml明显高于23.0 kg/m2≤BMI< 25.0 kg/m2亚组(P<0.05)。T2DM各亚组随FPG 、2 hPG 、HbA1c升高，HOMA-β、△I30/△G30呈进行性下降趋势;BMI≥25 kg/m2亚组HOMA-β、△I30/△G30高于23.0 kg/m2≤BMI< 25.0 kg/m2亚组和23.0 kg/m2亚组，但均低于NGT组。AUCI随FPG、2 hPG、HbA1c升高渐升高，当 FPG> 13.0 mmol/L、2 hPG >14.0 mmol/L和HbA1c >9%时开始下降;NGT组高于BMI 23.0 kg/m2亚组和23.0 kg/m2≤BMI< 25.0 kg/m2亚组，低于BMI≥25 kg/m2亚组。 结论 新诊断T2DM患者胰岛β细胞功能与其高血糖程度密切相关，血糖和HbA1c是简单反映胰岛β细胞功能的实用指标;非肥胖患者胰岛β细胞功能较肥胖者差。

　　【关键词】糖尿病，2型;血糖;糖化血红蛋白;体质指数;胰岛β细胞功能

　　【Abstract】 Objective To evaluate and analyze the related factors of islet β cell function in newly-diagnosed type 2 diabetics in order to provide reference for clinical management .Methods Oral glucose tolerance test(OGTT) and insulin release test were carried out in four hundred and fourteen patients with newly-diagnosed type 2 diabetes (T2DM) and one hundred and forty three normal glucose tolerance subjects(NGT) ,then HOMA-β cell function index(HOMA-β)，△I30/△G30 and insulin area under curve(AUCI)were calculated. 414 patients were divided into four groups by fasting plasma glucose(FPG), 2-h plasma glucose(2 hPG), BMI and HbA1c. Results (1) FIns among groups: FIns gradually increased with FPG, 2 hPG and HbA1c, when FPG> 10.0mmol / L, 2 hPG> 14.0mmol/L, HbA1c> 9%, FIns declined gradully; FIns increased more significantly in obesity group[(11.29±4.83)μIU/ml] thanin obesity group (P<0.05) when compared with the other groups.(2)HOMA-β, △I30 / with FPG, 2 hPG, HbA1c increased; HOMA-β and △ I30 / △ G30 were higher in obesity group than those in over-weight normal-weight group, but were lower than those in NGT group.③ AUCI among groups: AUCI increased with FPG, 2 hPG, HbA1c increased gradually , when FPG> 13.0 mmol / L, 2 hPG> 14.0mmol/L and HbA1c> 9%, AUCI declined gradually ; AUCI was higher in obese group than those in other groups. Conclusion The islet β cell function in newly-diagnosed type 2 diabetic patients is closely related to their degree of hyperglycemia and BMI, and blood glucose and HbA1c are simple and practical indicators for reflecting isletβ cell function;The islet β cells function poorly in non-obese diabetic patients when compared with that in obesity ones. G30 among groups:HOMA-β, △ I30 / △ G30 showed a progressive decline