2型糖尿病患者一级亲属第一时相胰岛素分泌及其组分的变化  

First-phase insulin secretion and its components in the first-degree relatives of type 2 diabetics

作　　者：李新荣[1] 朱本章[1] 

机构地区：[1]西安交通大学第一医院内分泌科,西安市中心医院710061

出　　处：《中华内分泌代谢杂志》2004年第5期413-416,共4页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的　探讨 2型糖尿病糖耐量正常的一级亲属胰岛素分泌第一时相和组分的变化 ,及其与2型糖尿病的关系。方法　以口服糖耐量正常的糖尿病一级亲属 (B组 ,3 5例 ) ,新诊断的 2型糖尿病患者(C组 ,3 5例 )及健康人群对照 (A组 ,2 1例 )为研究对象 ,放免法测定各组空腹及静脉葡萄糖耐量试验后血清免疫活性胰岛素 (IRI) ,ELISA法测定胰岛素原 (PI)、真胰岛素 (TI)水平。结果　 (1)空腹血清IRI、PI水平 :B组与A组间差异存在显著性 (均P <0 .0 5 ) ;TI水平 :B组与A组间差异无显著性 ;空腹血清IRI、TI水平 :B组与C组间差异无显著性 ;空腹PI :B组与C组间差异存在显著性 (P <0 .0 1)。 (2 )糖负荷后胰岛素分泌第一时相 :IRI及TI水平在B组与A组间差异无显著性 ;在B组与C组间差异有显著性 (P <0 .0 5 ) ;PI水平在B组与A组 ,A组与C组 ,B组与C组间均差异无显著性。结论　 2型糖尿病糖耐量正常的一级亲属可能存在 :(1)空腹高IRI血症及胰岛素抵抗 ;(2 )空腹胰岛素分泌组分存在异常 ,表现为空腹高PI血症 ;(3 )胰岛素分泌第一时相的IRI、TI、PI与正常人群相近 ;(4 )空腹血清PI可以作为 2型糖尿病的早期预测指标。Objective To investigate the changes of first-phase insulin secretion and its components in the first-degree relatives of Chinese type 2 diabetics with normal glucose tolerance and their correlation with type 2 diabetes. Methods The first-degree relatives of type 2 diabetes (Group B, n=35), newly diagnosed type 2 diabetic patients (Group C, n=35) and health subjects (Group A, n=21) were recruited. Immune reactive insulin (IRI), proinsulin (PI), and true insulin (TI) were determined during intravenous glucose tolerance test (IVGTT) in each subjects. IRI was determined with radioimmunoassay kit, while PI and TI with ELISA kits. Results (1) For the fasting sera, the levels of IRI and PI showed significant differences (both P<0.05) while the levels of TI were comparable between group B and group A;the levels of fasting IRI and TI were comparable while the levels of PI showed a significant statistical difference (P<0.01) between group B and group C;(2) In the first-phase of insulin secretion after glucose load, the levels of IRI and TI showed statistical differences between group B and group C (P<0.05), but were comparable between group B and group A;whilethelevelsofPI were comparable among 3 groups. Conclusion The first degree relatives of Chinese type 2 diabetics whose OGTT was normal may have following features: (1) fasting hyperinsulinemia and insulin resistance;(2) the components of insulin secretion are abnormal, showing fasting hyperproinsulinemia; (3) in the first-phase of insulin secretion, the levels of IRI, PI and TI are comparable with control group;(4) the level of PI in the fasting sera can be used as a predictive marker of type 2 diabetes mellitus in the early stage.

关 键 词：空腹 2型糖尿病 一级亲属 胰岛素分泌 糖耐量正常 时相 患者 PI 水平 显著性 

分 类 号：R587.1[医药卫生—内分泌] R589.1[医药卫生—内科学]