不同糖耐量人群中胰岛素原、真胰岛素与胰岛β细胞功能的相关性研究  

Correlation between proinsulin, true insulin and islet cell function in people with different glucose tolerance.

作　　者：陆雷群[1] 马晓英[1] 陈玲[1] 

机构地区：[1]上海交通大学附属瑞金医院卢湾分院内分泌科,上海200020

出　　处：《海南医学》2013年第11期1622-1624,共3页Hainan Medical Journal

基　　金：上海市卢湾区科委课题(编号:LKW1103)

摘　　要：目的探讨不同糖耐量人群中真胰岛素(TI)、胰岛素原(PI)与胰岛β细胞功能变化的临床意义。方法检测正常对照组(NGT)、糖耐量减退(IGT)组,糖尿病(DM)组各60例的空腹及2h血糖、免疫反应性胰岛素(IRI)、胰岛素原(PI)及真胰岛素(TI),采用稳态模型(HOMA Model)评估法计算胰岛β细胞功能指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)。结果 DM组的空腹PI水平、PI/IRI高于NGT组及IGT组,同时其TI/IRI低于NGT组及IGT组,且PI/IRI及TI/IRI在各组间差异具有统计学意义(P<0.05)。β细胞功能指数由IRI计算HOMA-βIRI,在DM组低于IGT组和NGT组(P<0.05);由TI计算的HOMA-βTI值,DM组和IGT组低于NGT组(P<0.05)。胰岛素抵抗指数无论是用IRI还是用TI计算的HOMA-IR均显示DM组>IGT组>NGT组(P<0.05)。结论 T2DM患者测定PI、TI水平可能较IRI更能反映胰岛β细胞水平和功能状况。Objective To study the changes and significance of serum true insulin （TI）, proinsulin （PI） and immune reactive insulin （1RI） in patients with different glucose tolerance. Methods The levels of serum TI, PI, IRI were tested by radioimmunoassay in 180 cases with different glucose tolerance, which were divided into normal control （NGT） group, abnormal glucose tolerance （IGT） group, diabetes mellitus （DM） group, with 60 cases in every group. The HOMA-IR and HOMA-β were calculated and analyzed with Homeostasis Model Assessment （HOMA）. Results The fasting PI level and PI/IRI in DM group were higher than those in NGT and IGT group, and the TI/IRI were lower than that in NGT and IGT group. PUIRI and TUIRI showed statistically significant difference between the three groups （P〈0.01）. The HOMA-βIRI calculated by IRI in DM group was lower than that in IGT and NGT group （P〈0.05）. The calculation of the TI HOMA-βTI value in DM and IGT group was lower than that in NGT group （P〈 0.05）. Insulin resistance index whether by IRI or by TI calculation HOMA-IR all showed that DM〉IGT〉 NGT （P〈 0.05）. Conclusion Determination of PI and TI, instead of IRI level, may reflect the true level and function of islet ceils in patients with T2DM.

关 键 词：胰岛素 胰岛素原 免疫反应性胰岛素 胰岛Β细胞功能 HOMA-β HOMA-IR 

分 类 号：R977.15[医药卫生—药品]