| Objective: By observing the changes of TG and HDL-C in newly diagnosed type 2diabetes mellitus,to explore the association between TG/HDL-C and insulin resistance and ?-cell function,and evaluate the risk factors for IR and ?-cell function.Methods: Two hundred and five newly diagnosed T2 DM patients from April 2015 to March 2016 in Shaanxi People's Hospital were enrolled,aged from 18-65 years old.All patients were not taking hypoglycemic and lipid regulating drugs.Two hundred healthy people with matched age and sex were collected as the control group.Measuring height(Ht),weight(Wt),waist circumference(WC)and hip circumference(HC).Total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),alanine transaminase(ALT),aspertate Aminotransferase(AST),uric acid(UA)and homocysteine(HCY)were detected by automatic biochemical analysis.The glycosylated hemoglobin A1c(HbA1c)was detected by high performance liquid chromatography.The fasting plasma glucose(FPG)was detected by glucose oxidase.The plasma fasting insulin(FINS)was examined by Chemiluminescence method.Body mass index(BMI),waist to hip ratio(WHR),insulin resistance index(HOMA-IR)and ?-cell function index(HOMA-?)were calculated respectively.The T2 DM group was divided into HOMA-IR?2.69 and HOMA-IR<2.69 group firstly,then divided into HOMA-??P25 and HOMA-?>P25 group,finally divided into three groups according to TG/HDL-C.The data were analyzed by independent sample t test,Pearson correlation analysis and multiple linear regression analysis.P<0.05 was considered as statistically significant.Results:1.Compared with the control group,BMI,TG,ALT,HbA1 c,UA,FPG,FINS,TG/HDL-C and HOMA-IR increased(P < 0.05)in T2 DM group,while HDL-C and HOMA-? decreased(P<0.05).2.In newly diagnosed T2 DM patients,compared with HOMA-IR<2.69 group,WC,WHR,BMI,TG,ALT,AST,FPG,FINS,TG/HDL-C,and HOMA-? increased in the HOMA-IR?2.69 group(P<0.05),while HDL-C decreased(P<0.05).Compared with HOMA-?>P25 group,HbA1 c and FPG increased in HOMA-??P25 group(P<0.05),while WHR,BMI,FINS and HOMA-IR decreased(P < 0.05).With the increase of TG/HDL-C level,HOMA-IR gradually increased(P<0.05).3.Taking HOMA-IR as dependent variable(Y),WC,WHR,BMI,ALT,AST,HCY and TG/HDL-C as independent variables(X1-X7),multiple stepwise regression analysis was performed.Finally,the independent variables entered into the regression equation were WC(X1)and TG/HDL-C(X7),and the determination coefficient R2 was 0.318,the correction coefficient was 0.311.Taking HOMA-? as dependent variable(Y),WC,BMI,TG,AST and HbA1 c as independent variables(X1-X5),multiple stepwise regression analysis was performed.Finally,the independent variables entered into the regression equation were BMI(X2)and HbA1c(X5),and the determination coefficient R2 was 0.280,the correction coefficient was 0.273.4.ROC curve analysis of HOMA-IR showed that the AUC area of TG/HDL-C was0.710(95%CI:0.639-0.781),the AUC area of TG was 0.701(95%CI:0.629-0.774),the AUC area of HDL-C was 0.363(95%CI:0.287-0.439),and the AUC area of WC was0.657(95%CI:0.582-0.731).ROC curve analysis of HOMA-? showed that the AUC area of HbA1 c was 0.734(95%CI:0.657-0.811),the AUC area of TG/HDL-C was 0.443(95%CI:0.358-0.528),and the AUC area of BMI was 0.351(95%CI:0.265-0.437).Conclusion:1.Dyslipidemia existed in newly diagnosed type 2 diabetic patients,and the main performances were increased TG and decreased HDL-C.2.TG/HDL-C may be a risk factor for insulin resistance in Chinese patients with newly diagnosed T2 DM.While no evidence to support that TG/HDL-C can predict HOMA-?.It suggests that TG/HDL-C may be a surrogate marker for predicting IR in clinical.3.The TG/HDL-C ratio had a certain accuracy in the diagnosis of HOMA-IR,but did not have diagnostic value for HOMA-?. |
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