应用高葡萄糖钳夹技术检测肥胖伴糖耐量异常者胰岛β细胞的功能变化  

Application of hyperglycemic clamp technique in the assessment of beta cell function in obese individuals with glucose intolerance

作　　者：包玉倩[1] 贾伟平[1] 朱敏[1] 陆俊茜[1] 陈蕾[1] 项坤三[1] 

机构地区：[1]上海交通大学附属第六人民医院内分泌代谢科上海市糖尿病研究所,200233

出　　处：《中华医学杂志》2004年第21期1781-1784,共4页National Medical Journal of China

基　　金：上海市科技发展基金资助项目 ( 0 14 1190 12 ) ;上海市医学发展基金重点研究课题资助项目 ( 0 12D0 0 2 11)

摘　　要：目的　应用高葡萄糖钳夹技术探讨糖耐量异常 (IGT)及糖尿病 (DM )个体胰岛素分泌功能的改变 ,以及与超重 /肥胖 (OW /OB)的关系。方法　根据糖耐量情况将上海地区 6 4例受试者分为正常糖耐量 (NGT)组、IGT组及DM组 ;再以体重指数 2 5kg/m2 为切割点 ,把不同糖耐量的受试者分成 6个组 :正常体重 (NW )NGT(NW NGT)组、NW IGT组、NW DM组、OW /OB NGT组、OW /OB IGT组、及OW /OB DM组。应用高葡萄糖钳夹技术研究IGT及DM个体各时相胰岛素分泌指数。结果　 (1)IGT及DM个体胰岛素分泌形态的变化表现 :第一时相胰岛素分泌进行性降低 (IGT 186mU/L± 38mU/L ,DM 71mU/L± 10mU/L ,P <0 0 5 ) ;第二时相胰岛素分泌明显减退 (IGT 70mU/L± 14mU/L ,DM 32mU/L± 4mU/L ,P <0 0 5 )。 (2 )NW IGT及NW DM者 ,第一时相 (NW IGT16 4mU/L± 4 7mU/L ,NW DM 6 1mU/L± 17mU/L)、第二时相 (NW IGT 4 4mU/L± 18mU/L ,NW DM 2 6mU/L± 5mU/L)及最大胰岛素分泌功能 (NW IGT 5 3mU/L± 2 1mU/L ,NW DM 34mU/L± 6mU/L)均显著减退 (P <0 .0 5 )。 (3)单纯OW /OB个体第一、第二时相胰岛素分泌指数及最大胰岛素分泌量显著高于NW NGT者 (分别为 5 4 6mU/L± 6 2mU/L、138mU/L± 18mU/L、16 3mU/L± 2 4mU/L ,P <0 0 5 ) ,OWObjective To study the changes of insulin secretion in Chinese individuals with impaired glucose tolerance and diabetes and the relationship between insulin release and overweight/obesity. Methods Sixty four individuals were divided into 6 groups according to glucose tolerance (GT) and body weight: normal weight with normal glucose tolerance (NW NGT) group, NW with impaired glucose tolerance (NW IGT) group, NW with diabetes (NW DM) group, overweight or obese (OW/OB) with NGT (OW/OB NGT) group, OW/OB with IGT (OW/OB IGT) group, OW/OB with DM (OW/OB DM) group. The subjects were required to fast for 12 hours and then underwent oral glucose tolerance test (OGTT) and hyperglycemic clamp. Results 1. The first phase insulin release, the sum of insulin concentrations during the first 10 minutes (at the 2 nd , 4 th , 6 th , 8 th , and 10 th minutes) were 186 mU/L±38 mU/L in the IGT groups, significantly lower than that of the NGT groups ( P =0.001). The first phase insulin release of the DM groups was 71 mU/L±10 mU/L, significantly lower than those of the NW NGT group and IGT group (257 mU/L±22 mU/L and 164 mU/L±47 mU/L respectively, both P <0 01). The second phase insulin release, the average insulin concentration during the 20th to 150th minutes of the DM groups was 31 mU/L± 4 mU/L, significantly lower than those of the NGT and IGT groups (74 mU/L±5 mU/L and 45 mU/L±19 mU/L, P <0 01 and P <0 04). The 2nd phase insulin release was not significantly different between the NGT and IGT groups ( P =0 13). The maximum insulin release (INS Max), the average insulin concentration during the last 30 minutes (120th to 150th minutes), of the DM groups was 40 mU/L± 6 mU/L , significantly lower than those of the NGT and IGT groups ( P <0 05). The INS MAX was not significantly different between the NGT and IGT groups ( P =0 12). The first phase insulin release, second phase insulin release, and INS MAX of the NW IGT group were 164 mU/L±47 mU/L, 45 mU/L�

关 键 词：IGT DM 时相 胰岛素分泌 OB NGT 糖耐量异常 最大 高分 个体 

分 类 号：R587.1[医药卫生—内分泌]