摘要
目的探讨老年T2DM患者Ins强化治疗后调节性T细胞(Tregs)水平变化与疗效的关系。方法选取2020年3月至2023年1月于我院内分泌科就诊的T2DM患者150例(T2DM组),同期于我院体检健康者150名作为正常对照(NC)组,根据Ins强化治疗疗效将T2DM组分为疗效明显亚组(n=86)和疗效不明显亚组(n=64)。结果与NC组比较,T2DM组FPG、Hb A1c、TC、TG、LDL-C、HOMA-IR升高,HDL-C、HOMA-β及Tregs降低(P<0.05)。与疗效不明显亚组比较,疗效明显亚组HOMA-β、Tregs上升百分比(ΔTregs)升高(P<0.05),年龄、DM病程、BMI、TG、FPG、Hb A1c及HOMA-IR降低(P<0.05)。Logistic回归分析显示,DM病程、FPG、Hb A1c、HOMA-β及ΔTregs是Ins强化治疗疗效的影响因素。限制性立方样条模型显示,随着ΔTregs升高,T2DM患者Ins强化治疗疗效良好的概率升高。受试者工作特征曲线分析显示,曲线下面积为0.823,敏感度、特异度为88.4%和87.6%,模型具有良好的区分度和准确性。结论Ins强化治疗后T2DM患者Tregs比例升高,ΔTregs是T2DM患者Ins强化治疗疗效的影响因素。
Objective To explore the relationship between the level of regulatory T cells(Tregs)and the therapeutic effect in elderly patients with type 2 diabetes mellitus(T2DM)after intensive insulin therapy.Methods 150 T2DM patients who visited in the endocrinology department of our hospital from March 2020 to January 2023 were selected as the T2DM group,and 150 healthy individuals who underwent physical exa mination at our hospital during the same period were selected as the normal control(NC)group.The T2DM group was divided into subgroups with significant therapeutic effects(n=86)and subgroups with unclear therapeutic effects(n=64)based on the efficacy of intensive insulin therapy.Results Compared with the NC group,FPG,Hb A1c,TC,TG,LDL-C,HOMA-IR increased in the T2DM group,while HDL-C and HOMA-βand Tregs decreased(P<0.05).Compared with the subgroup with unclear efficacy,HOMA-βand percentage increase of Tregs(ΔTregs)increased in the subgroup with significant sffcacy(P<0.05),while age,DM duration,BMI,TG,FPG,Hb A1c and HOMA-IR decreased(P<0.05).Logistic regression analysis showed that the DM duration,FPG,Hb A1c,HOMA-βandΔTregs were the influencing factors of the efficacy of intensive insulin therapy.The restricted cubic spline model showed that asΔTregs increases,the probability of good efficacy of intensive insulin therapy in T2DM patients increases.The analysis of the working characteristic curve of the subjects showed that the area under the curve is 0.823,with the sensitivity 88.4%and the specificity 87.6%,respectively.Conclusions After intensive insulin therapy,the proportion of Tregs in T2DM patients increased,ΔTregs are the influencing factors of the efficacy of intensive insulin therapy in T2DM patients.
作者
焦颖
张丹
张雪芹
李万福
JIAO Ying;ZHANG Dan;ZHANG Xueqin(Department of General Practice,Daxing District People's Hospital of Beijing,Beijing 102600,China)
出处
《中国糖尿病杂志》
CSCD
北大核心
2024年第12期918-922,共5页
Chinese Journal of Diabetes
关键词
糖尿病
2型
胰岛素强化治疗
调节性T细胞
疗效
Diabetes mellitus,type 2
Intensive insulin therapy
Regulatory T cells
Curative effect
