2型糖尿病一级亲属初诊糖尿病病人胰岛功能的变化及其影响因素  

CHANGES AND INFLUENTIAL FACTORS OF THE ISLET FUNCTION IN PRELIMINARILY-DIAGNOSED DIABETES PATIENTS WITH FIRST DEGREE RELATIVE HISTORY OF TYPE 2 DIABETES

作　　者：苗志敏[1] 王颜刚[1] 闫胜利[1] 袁鹰[1] 綦玉芹[1] 王娈[1] 付正菊[1] 

机构地区：[1]青岛大学医学院附属医院内分泌科,山东青岛266003

出　　处：《青岛大学医学院学报》2004年第3期189-191,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：①目的　明确 2型糖尿病一级亲属初诊糖尿病病人胰岛第一和第二分泌时相的变化及其影响因素。②方法　采用左旋精氨酸刺激法和口服 75 g葡萄糖耐量试验 (OGTT) ,观察 2 0例有糖尿病遗传史初诊 2型糖尿病(FH +)病人、2 2例无糖尿病遗传史初诊 2型糖尿病 (FH - )病人胰岛第一和第二分泌时相变化。③结果　两组 2min均达第一时相分泌峰值 ,4min开始下降。FH +组 2min峰值与第一时相胰岛素净分泌量均明显低于FH -组(t=1 2 .39、7.6 1 ,P <0 .0 1 )。FH +组第二分泌时相中早期分泌功能明显低于FH -组 (t =9.1 1 ,P <0 .0 1 )。两组第二分泌时相晚期分泌功能 (MBCI)及其各时点胰岛素无明显差异。两组病人胰岛素抵抗指数进入以第一时相胰岛素净分泌量为因变量的回归模型 (β′ =- 0 .2 0、- 0 .81 ,P均 <0 .0 1 )。FH -组病人早期分泌功能、空腹血糖和三酰甘油进入第二分泌时相胰岛素分泌量回归模型 (β′ =0 .70、- 0 .1 3、- 0 .0 3,P <0 .0 5、0 .0 1 )。FH +组无明显变化。④结论　在胰岛素抵抗和体质量指数、血糖、血脂相似的前提下 ,有遗传史初诊 2型糖尿病病人更容易出现胰岛素第一时相和OGTT试验中早期分泌异常 。Objective To study the changes and influential factors of the first and second phase islet β cell function of preliminarily diagnosed diabetes patients with first degree relative history of type 2 diabetes mellitus(DM). Methods The first and second phase insulin release of preliminarily diagnosed patients was observed by L arginine stimulation test and oral glucose tolerance test(OGTT) in 20 with a family history(FH+) and 22 without(FH-). Results The peak value of insulin secretion in both groups was at 2 min, and began to decrease at 4 min. However, the peak value and the net secretion in the FH+ group were significantly lower than those without a family history of type 2 diabetes (FH-group)( t=12.39,7.61;P <0.01).The early insulin secretion in the FH+ group was lower than in the FH- group( t=9.11,P <0.01). There was no difference of late insulin secretion between the two groups. Multiple step regression analysis showed that homeostasis model assessment of insulin resistance(Homa IR)entered regression model using the net insulin secretion of first phase as dependent variable in two groups( β′= -0.20 ,-0.81;P <0.01). The early insulin function, fasting glucose and triglycerides were elected into regression model using the net insulin secretion of second phase as dependent variable in FH- group( β′=0.70,-0.13,-0.03;P <0.05,0.01). However, no evident changes were observed in the FH+ group. \ Conclusion\ With similar Homa IR, body mass index, glucose,and lipidemia, the first insulin secretion and early secretion function were abnormal in FH+ patients compared with the FH- group, and the onset of the disease was early.

关 键 词：糖尿病 非胰岛素依赖型 一级亲属 胰岛 

分 类 号：R587.1[医药卫生—内分泌]