β-cell function and insulin sensitivity contributions on incident diabetes in patients with endogenous Cushing's syndrome
β-cell function and insulin sensitivity contributions on incident diabetes in patients with endogenous Cushing's syndrome
复制标题
DOI：
10.1016/j.diabres.2022.109994
复制
发表时间：
2022-07-19
影响因子：
5.1
通讯作者：
Zhang, Mei
中科院分区：
文献类型：
--
作者：
Gong, Ziye;Qin, Yao;Zhang, Mei
目的：目的：探讨内源性CS患者糖耐量恶化与胰岛β细胞功能和胰岛素敏感性的关系。方法：回顾性分析60例内源性CS患者的临床资料，通过OGTT检测糖代谢和胰岛β细胞功能。检索了它们的一般特征。计算用于评估胰岛素敏感性和β细胞功能的一系列参数。结果：60例CS患者中，CS/正常糖耐量（NGT）10例（16.7%），CS/糖尿病前期21例（35%），CS/糖尿病（DM）29例（48.3%）。与HC相比，CS/NGT患者的HOMA-IR较高，ISI-Matsuda较低，但HOMA-beta代偿性升高。在CS/NGT、CS/前驱糖尿病和CD/ DM组中观察到HOMA-β、AUCI/ G和. I30/. G30的显著下降趋势。与高AUCI/G/高ISI组相比，低AUCI/G/高ISI组发生糖尿病的OR值显著高于高AUCI/G/高ISI组。一种基于OGTT的方法可用于诊断CS患者的血细胞异常和β细胞功能障碍。
Objective: To evaluate the relative contributions of beta-cell function and insulin sensitivity on the deterioration of glucose tolerance from OGTT in patients with endogenous CS.Methods: We retrospectively analyzed the data of 60 patients with CS and determined the glucose metabolism and beta-cell function through OGTT. Their general characteristics were retrieved. A series of parameters for assessing insulin sensitivity and beta-cell function was calculated. The logistic regression model was used to investigate insulin sensitivity and beta-cell function contributions on incident diabetes.Results: Of the 60 patients with CS, 10 (16.7%), 21 (35%), and 29 (48.3%) were classified as CS/ normal glucose tolerance (NGT), CS/prediabetes, and CS/diabetes mellitus (DM). Compared with the HCs, the CS/NGT patients had higher HOMA-IR and lower ISI-Matsuda but with a compensatory increase in HOMA-beta. Significant decreasing trends were observed in HOMA-beta, AUCI/ G and.I30/.G30 among CS/NGT, CS/prediabetes and CD/ DM groups. The OR of incident diabetes compared with the high AUCI/G/high ISI group was significant in the low AUCI/G/high ISI group.Conclusion: Impairment of the beta-cell function had a more profound effect on incident diabetes than decreased insulin sensitivity. An approach based on an OGTT has utility for diagnosing dysglycaemia and beta-cell dysfunction in patients with CS.