The differences in homeostasis model assessment values in type 2 diabetic patients with different lengths of history of diabetes

ABSTRACT Objective Type 2 diabetes (T2DM) is characterized by the progressive deterioration of pancreatic islet β-cell function over time and insulin resistance. Knowing more about the differences in pancreatic islet function in T2DM patients who have had diabetes for different lengths of time can help improve therapy for T2DM. Subjects and methods We conducted a cross-sectional study to compare islet β-cell function and insulin resistance in T2DM patients (n = 3,254) who had had diabetes for different lengths of time and those in normal controls (n = 794) using ANOVA and LSD analysis. Results We found that compared with that in normal controls, HOMA-β in T2DM patients with a history of diabetes of less than 1 year was lower (approximately 52% of that of normal controls, p = 0.003), while HOMA-IR in these patients was higher (approximately 50% of that of normal controls, p = 0.007). Compared with that in other diabetic patients, HOMA-β in patients with a history of diabetes of more than 30 years was the lowest. HOMA-IR in patients with a history of diabetes of between 20 and 30 years was lower than that in other diabetic patients (p < 0.05). Conclusions There were obvious decreases in HOMA-β and increases in HOMA-IR in T2DM patients with a history of diabetes of less than 1 year compared with those in normal controls. Therefore, early screening and intervention for T2DM might help improve islet function and delay the progression of diabetes.

摘要
研究目的：2型糖尿病（Type 2 diabetes, T2DM）以胰岛β细胞功能（pancreatic islet β-cell function）随病程进展性减退及胰岛素抵抗（insulin resistance）为核心特征。充分了解不同病程的T2DM患者胰岛功能差异，有助于优化T2DM的临床治疗策略。
研究对象与方法：本研究采用横断面研究（cross-sectional study）设计，运用方差分析（ANOVA）与最小显著差异法（LSD），对比分析3254例不同病程的T2DM患者与794例正常对照者的胰岛β细胞功能及胰岛素抵抗水平。
研究结果：与正常对照人群相比，病程不足1年的T2DM患者稳态模型评估β细胞功能指数（HOMA-β）显著降低，仅为正常对照者的约52%（p=0.003）；而该组患者的稳态模型评估胰岛素抵抗指数（HOMA-IR）显著升高，约为正常对照者的50%（p=0.007）。与其余糖尿病患者相比，病程超过30年的T2DM患者HOMA-β水平最低；病程20~30年的患者HOMA-IR水平则低于其他糖尿病患者（p<0.05）。
研究结论：与正常对照者相比，病程不足1年的T2DM患者HOMA-β明显降低、HOMA-IR明显升高。因此，对T2DM开展早期筛查与干预，或可改善胰岛功能、延缓糖尿病的病情进展。