痛风病人胰岛β细胞分泌功能的研究  

AN ANALYSIS OF BETA-CELL FUNCTION IN PATIENTS WITH GOUT

作　　者：梁翠翠[1] 阎胜利[1] 王飞[1] 王娈[1] 綦玉琴[1] 耿超[1] 

机构地区：[1]青岛大学医学院附属医院内分泌科,山东青岛266003

出　　处：《青岛大学医学院学报》2012年第4期317-320,共4页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨痛风病人胰岛β细胞分泌功能的变化。方法选取2011年1—6月在我院门诊及住院的初诊痛风病人76例(单纯性痛风39例和痛风并发糖尿病前期37例)及同期来我院健康体检的正常对照30例(正常组),测定空腹血尿酸(UA)、空腹血糖(FPG)、血脂、肾功能、空腹胰岛素(FINS)及左旋精氨酸兴奋后2、4、6min胰岛素的水平,次日行口服75g葡萄糖耐量试验(OGTT),测定服糖后30、60、120min血糖、胰岛素的水平。结果痛风组与正常组比较,体质量指数(BMI)、腰围、FPG、120min血糖、FINS、胰岛素抵抗指数(HOMA-IR)、血UA、肌酐、尿素氮、胆固醇(TC)、三酰甘油(TG)明显升高(t=2.245～12.032,P<0.05)。精氨酸刺激后胰岛素分泌正常组胰岛素分泌均在2min达峰值,痛风组27.6%的病人在4～6min达峰值(χ2=10.337,P<0.05);痛风组分泌峰值高于正常组(t=2.538,P<0.05);痛风组胰岛素分泌曲线下面积(AUC)>正常组(t=2.806,P<0.05);正常组峰值升高倍数>痛风组(t=4.523,P<0.05)。葡萄糖刺激后胰岛素分泌正常组胰岛素分泌均在30～60min达峰值,痛风组67.1%的病人在30～60min达峰值(χ2=16.86,P<0.05);痛风组分泌峰值高于正常组(t=5.521,P<0.05);痛风组胰岛素分泌AUC>正常组(t=6.179,P<0.05)。单纯性痛风组17.9%病人OGTT胰岛素分泌在120min达峰值,痛风并发糖尿病前期组48.6%病人在120min达峰值(χ2=8.860,P<0.05)。BMI、腰围、UA与胰岛β细胞分泌功能相关(t=2.646～4.479,P<0.05)。结论痛风病人胰岛β细胞分泌功能代偿性增高,第一时相胰岛素分泌峰值升高倍数下降,胰岛β细胞第一和第二时相分泌均延迟,痛风并发糖尿病前期病人第二时相分泌延迟更为明显。Objective To explore the changes of islet β-cell function in patients with gout. Methods Seventy-six pa- tients with gout were recruited in this study, who were confirmed the diagnosis in our hospital during January-June, 2011. Of whom, 39 with normal blood glucose, and 37 complicating prediabetes. A control group consisted of 30 healthy persons. Fasting blood glucose, uric acid, blood fat, renal function, insulin, and insulin level after 2, 4 and 6 rain stimulation with L-arginine. The next day, an oral glucose tolerance test （OGTT, 75 g of glucose） was conducted, the blood glucose and insulin levels were meas- ured at 30, 60 and 120 rain after taking the glucose. Results Compared with normal control group, the body mass index （BMI）, waist circumference, fasting glucose, 1Z0-min glucose of OGTT, fasting insulin, HOMA-IR, blood UA, creatinine, urea nitrogen, TC, TG, in gout group were significantly elevated （t = 2. 245-12. 032, P〈0.05）. After stimulation with L-arginine, the insulin secretion in normal insulin secretion group reached its peak in 2 min; in gout group, 27.6% reached its peak in 4--6 min （χ^2=10. 337,P〈0. 05）; the peak value in gout group was higher than that in normal group （t=2. 538,P〈0.05） ~ Insulin secre- tion area under curve （AUC）：~normal group （t=2. 806,P〈0.05） the multiple of elevation of the peak value in normal group：〉 gout group （t=4. 523,P〈0.05）. After stimulation by glucose, in normal insulin-secretion group, all of the subjects reached the peak value in 30-60 rain, and in gout group, only 67.1% of the patients reached the peak （χ^2 =16.86,P〈0.05）. The peak value of secretion in gout group was higher than that in normal group （t = 5. 521, P〈0.05）, and AUC ：〉normal group （t = 6. 179, P〈 0.05）. In OGTT, 17.9 of the patients without complications reached the peak of insulin secretion in 120 min, and those compli- cating prediabetes, 48.60% （χ^2=8. 860, P〈0.05）. BMI, waist circumference and UA were positively c

关 键 词：痛风 糖尿病前期 胰岛Β细胞 胰腺功能试验 

分 类 号：R589.7[医药卫生—内分泌]