DM2患者血糖水平与胰岛素抵抗和β细胞功能关系的初步研究  

Study on the Relationship Between Blood Glucose Level and Insulin Resistance as Pancreatic β-cell Function in Patients with Type 2 Diabetes Mellitus (DM2)

作　　者：田小平[1] 黄慧健[1] 徐宁[1] 黄海波[1] 庄慧芹[1] 苏彩女[1] 郝志强[1] 何浩明[1] 

机构地区：[1]江苏省连云港市第一人民医院,222002

出　　处：《放射免疫学杂志》2005年第2期93-95,共3页Journal of Radioimmanology

摘　　要：目的:探讨不同血糖水平的2型糖尿病患者真胰岛素(TI)、胰岛素原(PI)、免疫反应性胰岛素(IRI)、免疫反应性C肽(IRC)间的相关性,初步分析胰岛素抵抗(Homa-IR)和β-细胞功能(Homa-β)与血糖水平的关系。方法:检测73例2型糖尿病患者的空腹和餐后TI、PI、IRI和IRC,将所有研究对象分为A组(空腹血糖,FBG≥8. 80mmol/L)和B组(FBG<8. 80mmol/L),用稳态模型(Homa-model)计算胰岛素抵抗(Homa-IR)和β细胞功能(Homa-β),分析A、B组TI、PI、IRI和IRC水平的相关性和Homa-IR、Homa-β在A、B组中的作用。结果:A、B两组以TI、IRI计算的Homa-β有显著性差异,以TI计算的Homa-IR无差异,而以IRI计算的Homa-IR有差异;A组C肽与免疫反应性胰岛素、真胰岛素和胰岛素原间的相关性不及B组;B组的TI、TI120显著高于A组,而IRI、IRI120、PI、PI120、CP、CP120无显著性差异。结论:β细胞功能的衰竭在糖尿病患者血糖水平的变化中可能是主要因素,胰岛素抵抗在高、低血糖的变动中可能维持在平衡状态。检测真胰岛素和胰岛素原在正确评价糖尿病患者胰岛素抵抗和胰岛β细胞功能有重要意义。糖尿病的防治可能应关注患者胰岛β细胞功能的变化。Objective To investigate the correlationship between serum immuno-reactive peptide (IR-CP) and true insulin (TI)、 pro-insulin (PI)、 immuno-reactive insulin (IR-I) contents and to calculate the insulin resistance (Home-IR)、 β-cell function (Homa-β) from these data in DM2 patients with different levels of fasting blood sugar (FBG<8.8 and ≥8.8mmol/L). Methods Fasting and 2h post-prandial serum TI, PI (with ELISA), IR-I, IR-CP (with RIA) contents were measureed in 73 patients with DM2 and Homa-IR, Homa-β were calculated with Homa-model from these data, The 73 DM2 patients were of two groups: GroupA, FBG≥8.8mmol/L, n=46; Group B, FBG<8.8mmol/L, n=27. Results The Homa-β calculated from either TI or IR-I was signifcantly different in Group A and Group B patients. Homa-IR calculated from IR-I was also significantly different in the two groups of patients; however, Homa-IR culculated from TI was about the same in the two groups. Correlationship between C peptide and TI, PI, IR-I was less ovious in Group A than that in Group B. Both fasting and 2h TI in Group B were significantly higher than those in Group A; the other parameters tested were not much different. Conclusion The higher FBG levels developed in Group A patients were mostly due to deterioration of β-cell function rather than increase of insulin resistance, as Homa-IR calculated from TI was not much different in the two groups. Further study on the management of diabetes should lay more emphasis on the change of β-cell function.

关 键 词：血糖 胰岛素抵抗 Β细胞功能 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]