2型糖尿病患者一级亲属外周血中真胰岛素和胰岛素原水平的临床意义  

Clinical Significance of Changes of Serum True Insulin and Proinsulin Levels in Relations of Patients with Type 2 Diabetes Mellitus

作　　者：田小平[1] 黄慧健[1] 黄海波[1] 吴岩[1] 何浩明[1] 

机构地区：[1]连云港市第一人民医院,222002

出　　处：《放射免疫学杂志》2004年第6期441-443,共3页Journal of Radioimmanology

摘　　要：目的 :探讨 2型糖尿病 (DM 2 )患者一级亲属的胰岛素抵抗和胰岛 β细胞分泌功能。 方法 :对家系DM 2患者 6 5例 (DM 2组 )、DM 2家系糖耐量减低患者 34例 (IGT组 )、DM2家系经OGTT证实糖耐量正常的一级亲属 6 6例 (NGT组 )及同期选择的无糖尿病及高血压家族史的糖耐量正常 4 8例 (NC组 )共四组 ,行75 gOGTT时测定免疫反应胰岛素 (IRI)、TI、PI,分析并比较各组间HOMA -IR和HOMA - β指标。 结果 :空腹PI水平在DM2、IGT、NGT组显著高于NC组 (t=2 .38,t=2 .16 ,t =1.95 ,P <0 .0 5 ) ,餐后PI水平IGT组显著高于NC组 (t=2 .31,P <0 .0 5 )。空腹TI在各组间无显著差别 ,餐后TI水平IGT组显著高于DM 2组(t=2 .0 6 ,P <0 .0 5 )。NGT和IGT组的空腹和餐后 2hIRI均显著高于NC组 (r =2 .13,t =2 .0 8,P <0 .0 5 )。DM2、IGT、NGT组的空腹PI/空腹IRI值显著高于NC组 (t =2 .39,t =2 .0 1,t =1.89,P <0 .0 5 )。DM 2、IGT组的空腹TI/空腹IRI值显著低于NC组 (t =1.89,t =1.96 ,P <0 .0 5 )。HOMA -IR指数在DM 2、IGT、NGT、NC组依次呈现出由高至低的趋势 ,且DM 2和IGT组显著高于NC组 (t=2 .16 ,t=2 .0 2 ,P<0 .0 5 )。DM2组HOMA - β细胞分泌指数显著低于IGT、NGT和NC组 (t=2 .4 0 ,t=2 .2 8,t=2 .0 3,P <0 .0 5 )。Objective To explore the degree of insulin resistance and β-cell secretory function impairment in close (1st degree) relations of patients with type 2 diabetes (DMⅡ). Methods Serum true insulin (TI), pro-insulin (PI), immunoreactive insulin (IRI) levels at fasting and after oral 75g glucose loading were determined in: ① patients with DM 2, n=65 ② relations of DM 2 patients with impaired glucose tolerance (IGT), n=34 ③ relations of DM 2 patients with normal glucose tolerance (NGT), n=66 and ④ controls, n=48. HOMA-IR and HOMA-β cell secretory indices were calculated from the data. Results Fasting serum PI levels were significantly higher in DM 2 patients, relations with IGT and NGT than those in the cortrols (t=2.38, t=2.16, t=1.95, P<0.05). After glucose loading, PI levels were significantly higher only in subjects with IGT (vs controls, t=2.31, P<0.05). Fasting serum TI levels were about the same in all the subjects tested. After glucose loading, TI levels were significantly higher in IGT group than those in DM 2 patients (t=2.06, P<0.05). Fasting and 2h after loading serum IRI levels were significantly higher in NGT and IGT groups than those in controls (t=2.13, t=2.08, P<0.05). Fasting PI/IRI values were significantly higher in DM 2 patients, IGT and NGT subjects than those in controls (t=2.39, t=2.01, t=1.89, P<0.05). However, fasting TI/IRI values were significantly lower in DM 2 patients and IGT subjects than those in controls (t=1.89, t=1.96, P<0.05). HOMA-IR index dropped progressively from DM 2 patients → IGT subjects → NGT → controls, with values in DM 2 and IGT significantly higher (vs controls; t=2,16, t=2.02, P<0.05). HOMA β-cell secretory index was significantly lower in DM 2 patients than those in the other 3 groups (t=2.40, t=2.28, t=2.03, P<0.05). HbA 1C percentages were significantly higher in DM 2 patients and IGT, NGT groups than those in controls (t=3.67, t=2.45, t=1.97, P<0.05). Fasting PI levels were positively correlated with HbA 1C percentage, fasting TI and IRI le

关 键 词：IGT 空腹 NGT DM2 一级亲属 患者 餐后 细胞分泌 水平 PI 

分 类 号：R587.1[医药卫生—内分泌] R285.5[医药卫生—内科学]