纳格列奈-口服葡萄糖耐量试验对检测正常人胰岛β细胞功能的评价  

The nateglinide-oral glucose tolerance test for assessing the pancreatic beta-cell function

作　　者：邓志明[1,2] 周智广[1] 杨琳[1] 谭少珍[1] 何凌[1] 陈小燕[1] 亓海英[1] 王建平[1] 

机构地区：[1]中南大学湘雅二医院内分泌科,代谢内分泌研究所,中南大学糖尿病中心,长沙410011 [2]湖南省常德市第一人民医院

出　　处：《中国糖尿病杂志》2007年第7期401-404,共4页Chinese Journal of Diabetes

基　　金：国家"十五"科技攻关项目(2001BA720B01);湖南省科技厅资助项目(02SSY3065);美国礼来亚洲公司科研基金资助项目(7282/B5K-GH-0435)

摘　　要：目的优化纳格列奈-口服葡萄糖耐量试验(NG-OGTT)评估胰岛β细胞功能的方法。方法对24例健康志愿者进行NG-OGTT,测定各设定时间点(-15、0、10、20、30、45、60及120min)的胰岛素和血糖水平。胰岛素测定采用放射免疫法。观察NG-OGTT中胰岛素释放的峰值,胰岛素释放倍增值(MVI),各设定时间点的胰岛素释放曲线下面积(AUCIns)、胰岛素释放速率(IRV)、胰岛素净增值与血糖净增值的比值(△I/△G),筛选出NG-OGTT中最能反映胰岛β细胞分泌与储备功能的时间点。结果(1)正常人在NG-OGTT中反映胰岛β细胞早期相分泌功能的胰岛素释放峰值(90.50mU/L)与IRV(2.75mU.L-1.min-1)的达峰时间均在糖负荷后30min;(2)其△I/△G的达峰时间虽在糖负荷后45min(56mU/mmol),但45min时该值的升高主要由血糖的快速降低引起;(3)反映β细胞储备功能的MVI(18.8)的达峰时间亦在糖负荷后30min;(4)其AUCIns在60min时与120min具有显著性相关(r=0.901,P=0.000)。结论糖负荷后采用-15、0、30和60min4个采血点,能反映β细胞早期相分泌功能及储备功能,方法简便。Objective To simplify the method of nateglinide-oral glucose tolerance test （NG-OGTT） for assessment of islet beta-cell function. Methods NG-OGTT was performed in 24 healthy volunteers, With regard to NG-OGTT, blood samples for glucose and insulin detection were drawn at -15, 0, 10, 20, 30, 45, 60 and 120 min to evaluate the insulin release peak value, multiplying value of insulin （MVI）, insulin release rate （IRR）, ratio of △insulin/△glucose and the area under insulin release curve （AUCIns）, and to select the optimal point, at which these parameters could reflect the best islet beta-cell secretion and storage. Results （1）In NG-OGTT, the insulin release peak value （90.50 mU/L） and fastest point of IRR （2.75 mU·L^-1·min^-1） which reflect early insulin secretion were at 30 min after glucose load. （2） The peak value of the ratio of △insulin/△glucose was at 45 min（56 mU/mmol）, but the rising of △insulin/△glucose was caused by fast reduction of plasma glucose. （3） The optimal point of MVI（18.8）which reflects storage capacity was also at 30 min. （4） The AUCIns60mi, had maximal correlation with AUCIns120min （r = 0. 901, P = 0. 000） . Conclusions In NG-OGTT, we need only four time points （-15, 0, 30, 45, 60 min） in assessment of islet beta-cell function and 30 min after glucose load was a key point. Simplified NG-OGTT was a relatively precise, simple and practical method for evaluation of islet beta-cell secretion and storage function.

关 键 词：纳格列奈 葡萄糖耐量试验 胰岛 

分 类 号：R446.1[医药卫生—诊断学]