·糖尿病临床研究·

　　【摘要】 目的 了解成人隐匿性自身免疫糖尿病(LADA)患者晚餐前高血糖与胰岛β细胞功能及皮质醇水平的相关性。 方法 选取合并晚餐前高血糖LADA患者32例为试验组，不合并晚餐前高血糖LADA患者39例为对照1组及T2DM患者30例为对照2组。检测各组FPG、C-P、HbA1c及皮质醇水平，采用改良HOMA公式计算胰岛素分泌指数(HOMA-islet)，评价胰岛β细胞功能。 结果 试验组HOMA-islet低于对照1组和对照2组[(17.1±8.9) vs (35.1±16.5) vs (69.5±27.1)，P<0.05]，但三组皮质醇水平比较，差异无统计学意义。Logistic回归分析结果显示，晚餐前高血糖与HbA1c、BMI及HOMA-islet相关(OR=0.31、5.53、1.31,P<0.05)，与皮质醇水平无相关性。 结论 晚餐前高血糖现象提示胰岛β细胞功能损伤的指标之一，其与皮质醇水平无关。

　　【关键词】 成人隐匿性自身免疫糖尿病;晚餐前高血糖;胰岛β细胞功能;皮质醇

　　【Abstract】 Objective To investigate the relationship between hyperglycemia before the supper and the islet beta cell function in patients with latent autoimmune diabetes in adults(LADA). Method 32 LADA patients with the hyperglycemia before the supper(Experiment group) and, 39 without the hyperglycemia before the supper(Control 1 group), and 30 T2DM patients(Control 2 group) were enrolled.The FPG , C-P , HbA1c and plasma cortisol were tested. The HOMA-islet was calucated by using the modified Homa formula to evaluate the islet beta cell function. Results The result of HOMA-islet was lower in experiment group than in control 1 and control 2 groups[(17.1±8.9) vs (35.1±16.5) vs (69.5±27.1)，P<0.05],but The the plasma cortiso levels were no differences among three groups. Logistic regression analysis showed that HbA1c, BMI and HOMA-islet was associated with the hyperglycemia before supper(OR=0.31,5.53,1.31,P<0.05), and there was no correlation with plasma cortisol levels. Conclusion The hyperglycemia before the supper may be a index of the islet beta cell failure, and it is not related to the change of plasma cortisol levels.

　　【Key word】 Latent autoimmune diabetes in adults(LADA); Hyperglycemia before the supper; Islet beta cell function; Plasma cortisol