【摘要】 目的比较C肽和胰岛素在评估胰岛素抵抗性(IR)的差异。方法依口服糖耐量试验将2003年3月至2004年3月中国医科大学附属第二医院门诊及周围社区的44例汉族人分为正常糖耐量(NGT)组、孤立空腹血糖受损(I-IFG)组、孤立糖耐量受损(I-IGT)组,联合糖耐量受损(C-IGT)组。观察葡萄糖钳夹试验测定的IR指标(葡萄糖输注速率,GIR)和其空腹胰岛素、C肽的关系。结果I-IFG、I-IGT、C-IGT组的GIR明显低于NGT(P<0.01),但各组的空腹C肽浓度差异无显著性。各组的胰岛素作用指数(IAI)、稳态模式评估法指数(HOMA-IR)、空腹胰岛素衍生的IR指标定量胰岛素敏感性检测指数(QUICKI)与GIR均呈良好相关(P<0.05),相关系数在0.766~0.498之间,但空腹C肽替代胰岛素后的IR指标与GIR无明显相关,相关系数在0.394~0.042之间(P>0.05)。结论空腹C肽质量浓度和胰岛素抵抗程度没有相关性。更多还原

【Abstract】 Objective To compare the differences between C-peptide and insulin in evaluation of insulin resistance.Methods From 2003 to 2004,according to oral 75 g glucose tolerance test(OGTT),44 subjects were divided into normal glucose tolerance(NGT)group,isolated impaired fasting glucose(I-IFG)group,isolated impaired glucose tolerance(I-IGT)group and combined impaired glucose tolerance(C-IGT)group.We discussed the relationship between glucose infusion rate(GIR)by hyperinsulin euglycemic clamp and IAI,HOMA-IR,QUICKI(these indexes from fasting insulin level),fasting C-peptide level,respectively.Results (1)GIR of I-IFG,I-IGT,C-IGT groups declined significantly compared with that of NGT group(P<0.01),fasting C-peptide concentrations of I-IFG,I-IGT,C-IGT groups were at similar level,being 1.36±0.16,1.28±0.20,1.56±0.37,1.56±0.23,respectively(P>0.05).IAI,HOMA-IR and QUICKI of each group were of good relation to GIR respectively(P<0.05),with the relative rate in the range of 0.766~0.498,but substituting insulin with fasting C-peptide,all the mended indexes of each group related to GIR had no significant relation(P>0.05),whose relative rates were among 0.394~0.042.Conclusion The level of fasting C-peptide has no relationship wiht the degree of insulin resistance.更多还原