Study On The Influential Factors Of Beta-cell Function And Microvascular Complications In Patients With Type 2 Diabetic

OBJECTIVE: To investigate the influential factors of beta-cell function in patients with type 2 diabetic and analyze the risk factors of diabetic microvascular complications.METHODS: 101 patients with type 2 diabetes mellitus were selected from the Department of Endocrinology between January 2008 and January 2009. The clinical information were collected and the body weight, body height, waist circumference (WC), hip circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), 2 hours postprandial glucose (2hPG), glycosylated hemoglobin (HbA1c), fasting C-peptide, blood fat and bone density were measured. All the patients were divided into two groups according to FPG. The correct homeostasis model assessment for beta-cell function (Homa2-%β) was used to assess the beta-cell function. The Correct homeostasis assessment for insulin resistance ( Homa2-IR ) was calculated to assess insulin resistance. Diabetic retinopathy, diabetic renal disease and diabetic peripheral neuropathy were diagnosed by neural electromyogram (EMG), fundus examination, the serum cystatin C, glomerular filtration rate, urinary albumin and urine creatinine. Multivariate logistic regression was taken between risk factors and present of diabetic microvascular chronic complications.RESULTS: 1 After adjustment of other influential factors, Homa2-%βhad a negative relation with FPG, 2hPG and HbA1c. Homa2-IR had a positive relation with BMI, WC, WHR, WHtR, TG, trunk fat and total body fat. In addition trunk fat and TG had a good linear relationship with Homa2-IR. 2 The frequency of chronic diabetic complications was as follows: diabetic retinopathy 38.6% (39 cases), diabetic peripheral neuropathy 54.4% (55 cases), diabetic nephropathy 39.6% (40 cases). 3 Multivariate logistic regression analysis showed: (1) The duration of diabetes, DBP, and TC were independent risk factors to diabetic retinopathy. However, Homa2-%βwas a protect factor to diabetic retinopathy. (2) The duration of diabetes, SBP and HbA1c were independent risk factors to diabetic peripheral neuropathy. (3) The duration of diabetes, HbA1c, SBP and Homa2-IR were independent risk factors to diabetic renal disease.CONCLUSIONS: The glucotoxicity and lipotoxicity were the important factors which impaired the beta-cell function and severe insulin resistance existed in type 2 diabetes mellitus patients with abdominal obesity. The duration of diabetes, SBP, DBP, HbA1c, TC, beta-cell dysfunction and insulin resistance were the important independent risk factors to diabetic chronic microvascular complications.