ABSTRACT
Objective To analyze the correlation between glycated hemoglobin index(HGI)and insulin antibody(IAA)positivity in type 2 diabetes mellitus(T2DM)patients with poorly controlled oral hypoglycemic agents.Methods A total of 260 T2DM patients with poor control of oral hypoglycemic agents and receiving insulin treatment in the Department of Endocrinology of Orthopedics and Diabetes Hospital of Haikou City from January 2020 to December 2021 were selected and divided into IAA positive group(n=75)and IAA negative group(n=185).Clinical data and biochemical indicators of the two groups were compared and analyzed the correlation between IAA positivity and other indicators.Results IAA positive group had a higher proportion of patients with insulin high dosage,insulin treatment time>2 years,and higher FIns,FPG,SUA and HGI than IAA negative group(P<0.05 or P<0.01),HbA1c≥9%lower than IAA negative group(P<0.01).Spearman correlation analysis showed that IAA positive was positively correlated with HGI(P<0.01),and negatively correlated with SUA and HDL-C(P<0.01).Logistic regression analysis showed that insulin treatment time,FIns,FPG,SUA,HbA1c and HGI were the influencing factors for IAA positive in T2DM patients.Receiver operating characteristic curve analysis showed that the area under the ROC curve for predicting IAA positive by HGI was 0.854,the optimal critical value for HGI was 0.4%,with the sensitivity 83.2%and the specificity 79.3%.Conclusion In T2DM patients with poorly controlled oral hypoglycemic drugs,high HGI has predictive value for IAA positivity.
ABSTRACT
Hemoglobin is the predominent pigment in the gastrointestinal mucosa, and the development of electronic endoscopy has made it possible to quantitatively measure the mucosal hemoglobin volume, by using a hemoglobin index (IHb). The aims of this study were to make a software program to calculate the IHb and then to investigate whether the mucosal IHb determined from the electronic endoscopic data is a useful marker for evaluating the color of intramucosal gastric carcinoma with regard to its value for discriminating between the histologic types. We made a software program for calculating the IHb in the endoscopic images. By using this program, the mean values of the IHb for the carcinoma (IHb-C) and those of the IHb for the surrounding non-cancerous mucosa (IHb-N) were calculated in 75 intestinal-type and 34 diffuse-type intramucosal gastric carcinomas. We then analyzed the ratio of the IHb-C to the IHb-N (C/N ratio). The C/N ratio in the intestinal-type carcinoma group was higher than that in the diffuse-type carcinoma group (p<0.001). In the diffuse-type carcinoma group, the C/N ratio in the body was lower than that in the antrum (p=0.022). The accuracy rate, sensitivity, specificity, and the positive and negative predictive values for the differential diagnosis of the diffuse-type carcinoma from the intestinal-type carcinoma were 94.5%, 94.1%, 94.7%, 88.9% and 97.3%, respectively. IHb is useful for making quantitative measurement of the endoscopic color in the intramucosal gastric carcinoma, and the C/N ratio by using the IHb would be helpful for distinguishing the diffuse-type carcinoma from the intestinal-type carcinoma.