【作者】 朱红霞； 易本谊； 刘精东； 陈勇； 曾竹青； 曾黎峰；

【Author】 ZHU hong-xia,YI ben-yi,LIU jing-dong,CHEN yong,ZENG zhu-qing,ZENG li-feng Department of Diabetes,Jiu jiang Chinese Traditional Medicine Hospital,Jiu jiang,Jiang xi Province,332000,China

【机构】 江西省九江市中医院糖尿病科； 九江学院医学院内科教研室； 江西省人民医院内分泌科； 江西省人民医院检验科；

【摘要】 目的探讨血糖调节异常(IGR)及初诊2型糖尿病(T2DM组)患者早期相胰岛素分泌情况及其组分的变化。方法研究32例IGR,其中空腹血糖受损者(IFG组,12例),糖耐量减低者(IGT组,20例),23例T2DM及25例健康人群对照(NGT组),分别测定各组空腹及口服葡萄糖耐量试验(OGTT)后血清免疫活性胰岛素(IRI)、血清胰岛素原(PI)与真胰岛素(TI)水平,对结果进行统计学分析。结果 (1)①空腹血清IRI水平:IFG、IGT、初诊T2DM组均高于NGT组(P<0.05)。②空腹血清PI水平:初诊T2DM组高于IGT组,但差异无显著性(P>0.05),初诊T2DM组高于IFG组(P<0.05)及NGT组(P<0.01)。③空腹血清TI水平:四组间比较均无显著差异(P>0.05)。(2)PI/IRI值:IGT组及初诊T2DM组明显高于NGT组(P<0.05);TI/IRI值:初诊T2DM组明显低于NGT组,差异有显著性(P<0.05)。(3)△IRI30/△G30:初诊T2DM组及IGT组明显低于NGT组(P<0.05);△TI30/△G30:IGT及初诊T2DM组均明显低于NGT组(P<0.05),初诊T2DM组明显低于IGT组(P<0.05)。结论 1.IGT者及初诊T2DM患者早期相胰岛素分泌组分存在异常,表现为空腹高PI血症,并且随着血糖异常程度损害的加重,PI/IRI值逐渐升高;2.IGT者及初诊T2DM患者存在早期胰岛素分泌功能缺陷,且初诊T2DM患者损害程度高于IGT者;3.△TI30/△G30比△IRI30/△G30更能真实反映IGT者与初诊T2DM患者早相胰岛素分泌功能的差别。更多还原

【Abstract】 Objective To investigate the changes of early phase insulin secretion and its components in impaired glucose regulation(IGR) individuals and newly diagnosed type 2 diabetes mellitus(T2DM).Methods 32 cases of(IGR) patients which is composed of impaired fasting glucose patients(IFG,n=12) and impaired glucose tolerance patients(IGT,n=20),newly diagnosed T2DM(n=23)and health subjeccts with normal glucose tolerance(NGT,n=25) were selected.The fasting and post glucose load plasma immunoreactive insulin(IRI) were measured by radioimmuno-assay.True insulin(TI) and proinsulin(PI) of fasting and 30 min after oral glucose tolerance test were measured by enzyme-linked immuno assay(ELISA),and the results were analysed by statistic method.Results(1) ①Fasting IRI:T2DM、IFG、IGT>NGT(P<0.05).②FPI: T2DM>IGT(P>0.05),T2DM>IFG(P<0.05)and NGT(P<0.01).③FTI:There was no significant difference among groups.(P>0.05);(2)PI/IRI:Compared with NGT,the ratio of PI/IRI increased significantly in groups of IGT and T2DM(P<0.05);TI/IRI:Compared with NGT,the ratio of TI/IRI decreased significantly in group of T2DM(P<0.05);(3) △I RI30/△ G30:The groups of T2DM and IGT present significant lower ratio than NGT(P<0.05);△ TI30/△ G30 :Compared with NGT,the groups of IGT and T2DM showed higer ratio(P<0.05);The group of T2DM was significantly lower than IGT(P<0.05).Conclusion(1) The components of FINS was abnormal in impaired glucose regulation and diabetse patients who showed high plasma fasting proinsulin(FPI),and with the development of impaired β cell secretion function,the ratio of PI/IRI increased gradually.(2)The early insulin seretion function was inpaired in patients with IGT and T2DM,and the impaired degree was more serious in T2DM than IGT.(3) The ratio of △ TI30/ △ G30 was more sensitive than △I RI30/ △G 30 to reflect difference between groups of IGT and T2DM in early phase insulin secretion.更多还原