成人隐匿性自身免疫性糖尿病胰岛素抵抗与β细胞功能的研究  

Relationship between insulin sensitivity and the functionof islet β cell in patients with latent autoimmunediabetes in adults

作　　者：石昌红[1] 高聆[1] 马春燕[1] 崔彬[1] 刘国立[1] 管庆波[1] 赵家军[1] 

机构地区：[1]山东大学山东省立医院

出　　处：《山东医药》2005年第25期9-11,共3页Shandong Medical Journal

基　　金：山东省医药卫生科技发展计划项目(1999-40)

摘　　要：目的探讨成人隐匿性自身免疫性糖尿病(LADA)患者的胰岛素抵抗(IR)与胰岛β细胞功能的关系。方法对40例LADA、40例速发性1型糖尿病(T 1DM)、50例2型糖尿病(T 2DM)患者和30例正常健康者(对照组)进行了身高、体重、空腹和餐后2h血糖、空腹胰岛素、糖化血红蛋白(HbA1C)、血脂、24h尿蛋白检测,并做眼科检查、周围神经电生理检查、下肢血管彩超,计算体重指数(BM I)、腰臀围比(WHR)、胰岛素抵抗指数(HOM A-IR)和胰岛素释放指数(HOM A-IS)。结果LADA患者HOM A-IR和HOM A-IS高于T 1DM,低于T 2DM(P均<0.01)。LADA患者病程5a内下肢血管病变及其病变危险因素低于T 2DM(P<0.05),与T 1DM相似;微血管病变三组间比较无差异。结论LADA患者既存在IR,又有胰岛β细胞分泌功能不足。Objective ：To investigate the relationship between insulin sensitivity and insulin function in patients with latent autoimmune diabetes in adults （LADA）. Methods ：The levels of blood glucose,lipid,fasting insulin, C-peptide, height, weight, 24h urinary albumin, HbAlc, BMI, waist-to-hip ratio were measured in 40 LADA patients, 40 type 1 diabetic with rapid progression patients, 50 type 2 diabetic patients and 30 control cases. The homeostasis model assessment insulin resistance （HOMA-IR） and homeostasis model assessment insulin secretion （HOMA-IS） were caculated in four groups. Results ： The HOMA-IR and HOMA-IS of LADA patients were higher than type 1 diabetes,while was lower than type 2 diabetes. The macrovascular complications and risk factors of LADA patients were lower than type 2 diabetes, while were similar to type 1 diabetes within 5 years. There were no differences in the prevalence of microvascular complications in three subjects. Conclusions： The progression of LADA were linkage to the insulin resistance and islet cell function deficiency.

关 键 词：成人隐匿性自身免疫性糖尿病 胰岛素抵抗 胰岛β细胞功能 胰岛细胞抗体 谷氨酸脱羧酶抗体 

分 类 号：R587.1[医药卫生—内分泌]