肥胖症患者和新诊断的2型糖尿病患者真胰岛素和前胰岛素的改变  

Plasma true insulin and proinsulin in obese and newly diagnosed type 2 diabetic patients

作　　者：杨建梅[1] 高妍[1] 马红 惠岩[1] 陈澜[1] 

机构地区：[1]北京医科大学第一医院内分泌科,邮政编码100034

出　　处：《中国糖尿病杂志》2000年第5期285-288,共4页Chinese Journal of Diabetes

摘　　要：目的　了解真胰岛素 (true insulin,TI)和前胰岛素 (proinsulin,PI)在肥胖症和 2型糖尿病患者中的改变 ,了解免疫活性胰岛素 (immunoreactive insulin,IRI)能否准确反映 TI。方法　 33例糖耐量正常 (NGT)、2 4例糖耐量减低(IGT)和 5 3例新诊断的 2型糖尿病患者行口服葡萄糖耐量实验 ,并根据体重指数 (BMI)分为肥胖和非肥胖组 ;采用EL ISA方法 (其单克隆抗体能准确区分 TI和 PI)测定 TI和 PI;采用放射免疫方法测定 IRI。结果　 NGT肥胖组空腹、餐后 30分钟、6 0分钟和 12 0分钟 TI明显高于 NGT非肥胖组 ,糖尿病非肥胖组餐后 30分钟、6 0分钟 TI明显低于 NGT非肥胖组 ,糖尿病肥胖组空腹及餐后 12 0分钟 TI明显高于 NGT非肥胖组 ,IGT非肥胖组餐后 30分钟 TI明显低于 NGT非肥胖组。 IGT肥胖组餐后 12 0分钟 TI明显高于 NGT非肥胖组。 PI/ IRI在糖尿病非肥胖组和糖尿病肥胖组明显高于NGT非肥胖组。 TI/ IRI在 NGT肥胖组、糖尿病非肥胖组、糖尿病肥胖组和 IGT肥胖组均明显低于 NGT非肥胖组。结论　肥胖者、肥胖的 IGT患者和肥胖的新诊断的 2型糖尿病患者具有高胰岛素血症。2型糖尿病患者具有不成比例的前胰岛素的增高 ,免疫活性胰岛素常常过高估计肥胖者、2型糖尿病和 IGT患者的胰岛素水平。Objective To study the changes of true insulin (TI) and proinsulin (PI) in obesity and type 2 DM patients and to study the validity of immunoreactive insulin (IRI) in reflection of the level of insulin.Methods 33 cases with normal glucose tolerance (NGT),24 cases with impaired glucose tolerance (IGT) and 53 cases with newly diagnosed type 2 DM were subdivided into obese and non-obese groups.TI and PI were measured by ELISA using monoclonal antibody with no significant cross-reaction between insulin and proinsulin.IRI was measured routinely.Results Fas ting ,30 min,60 min and 120 min TI after a glucose loading in obese group with NGT were significantly higher than those in non-obese group with NGT.30 min and 60 min TI in non-obese group with DM were significantly lower than those in non-obese group with NGT.Fasting and 120 min TI in obese group with DM were significantly higher than those in non-obese group with NGT.30 min TI in non-obese group with IGT was significantly lower than that in non-obese group with NGT.120 min TI in obese group with IGT was significantly higher than that in non-obese group with NGT.Fasting PI/IRI in obese and non-obese group with DM was significantly higher than that in non-obese group with NGT.Fasting TI/IRI among obese group with NGT,non-obese group with DM,obese group with DM and obese group with IGT were significantly higher than that in non-obese group with NGT.Conclusion The individuals with obesity,obese IGT and obese newly diagnosed type 2 DM have true hyperinsulinemia.The patients with type 2 DM have disproportionally increased PI/IRI.IRI may overestimate insulin levels in individuals with obesity,type 2 DM and IGT.

关 键 词：胰岛素 肥胖症 2型糖尿病 前胰岛素 

分 类 号：R587.102[医药卫生—内分泌] R589.202[医药卫生—内科学]