胰高血糖素与2型糖尿病及糖调节异常的相关性研究  

Study on correlation of glucagons,type 2 diabetes and impaired glucose regulation

作　　者：徐涛[1] 石梅[1] 邱云霞[1] 王颜刚[2] 

机构地区：[1]胜利石油管理局胜利医院内分泌科,山东东营257055 [2]青岛大学医学院附属医院内分泌科,山东青岛266003

出　　处：《中国中药杂志》2014年第12期2356-2363,共8页China Journal of Chinese Materia Medica

摘　　要：目的:分析不同阶段的2型糖尿病患者,在空腹、糖耐量(OGTT)、左旋精氨酸(L-Arg)实验中胰腺αβ细胞分泌的胰高血糖素(GC)、胰岛素,游离脂肪酸(FFA)的变化;通过对胰高血糖素(GC)、游离脂肪酸(FFA)与血糖(BG)、胰岛素(INS)、胰岛素稳态模型(HOMA)、糖代谢激素分泌曲线等指标之间的关系的研究,来探讨胰腺αβ细胞在糖尿病发病机制中所起作用,为糖尿病的治疗提供理论依据。方法:3组研究对象,包括T2DM组45例、IGR组28例、NGT组30例,分别行糖耐量(OGTT)、次日行左旋精氨酸(L-Arg)实验。检测空腹状态下的血糖(FBG)、胰岛素(F)、胰高血糖素(FGC)、游离脂肪酸(FFA),计算各组的胰岛素稳态模型(HOMA-β),胰岛素敏感指数(ISI),HOMA-IR;同时计算OGTT,L-Arg试验中检测的不同时间段并计算曲线下面积AUCBG,AUCINS,AUCGC。结果:3组研究对象中的FGC和FFA均有总体差异;各组的FGC均与HOMA-β,ISI负相关,与HOMA-IR正相关;在所有的103例研究对象中,FGC与FBG,HOMA-IR正相关,与FINS无相关性,与HOMA-β,ISI负相关;FFA与FBG,HOMA-IR正相关,与FINS,HOMA-β,ISI负相关;FGC与FFA之间,在T2DM组和IGR组正相关,在NGT组无统计学相关。3组研究对象在OGTT中GC曲线下面积表现为T2DM>IGR>NGT,L-Arg实验中GC曲线下面积表现为T2DM>IGR>NGT;AUCGC与AUCBG显著正相关、与AUCINS显著负相关。结论:发现T2DM和IGR患者胰高血糖素和游离脂肪酸水平升高,其升高的程度与血糖、HOMA-IR正相关,与INS,HOMA-β,ISI负相关。在T2DM和IGR患者,胰高血糖素升高,提示2型糖尿病人不仅存在胰腺β细胞分泌异常,且存在α细胞的分泌异常。Objective： To analyze the changes of patients with type 2 diabetes in different stages in glucagon （GC） and free fatty acid （FFA） in fasting, OGTT and L-Arg experiments, and discusses the role of pancreatic αβ cells in diabetes pathogenesis by studying the relations among indexes such as glucagon （GC）, free fatty acid （FFA）and blood glucose （BG）, insulin, insulin homeostasis model （HOMA） and glucose metabolism hormone secretion curve, in order to provide theoretical basis for the treatment of diabetes. Method： Study objects were divided into the T2DM group （45 cases）, the IGT group （28 cases） and the NGT group （30 cases） for an OGTT experiment and then an L-Arg experiment on the next day. Under the fasting state, their blood glucose （FBG）, insulin （F）, glucagon （FGC）, free fatty acid （FFA） were detected to calculate HOMA-β, insulin sensitivity index （ISI） and HOMA-IR of different groups. Meanwhile, efforts were made to calculate different time quantum detected in OGTT and L-Arg experiments and area under the curve AUCBG, AUCINS and AUCGC. Result： Obvious overall differences were observed in FFA and FGC of the three groups. FGC of each group was negatively correlated with HOMA-β and ISI. Among all of the 103 study objects, FGC was positively correlated with FBG and HOMA-IR and negatively correlated with HOMA-β and ISI, with no correlation with FINS; FFA was positively correlated with FBG, HOMA-IR and negatively correlated with FINS, HOMA-β, ISI. FGC and FFA were positively correlated in the T2DM group and the IGT group, but with no statistical correlation in the NGT group. The sequence of the three study objects was T2DM〉IGR〉NGT in AUCGC in the OGTT experiment and T2DM〉IGR〉NGT in in AUCGC in the L-Arg experiment, with the significant positive correlation between AUCGC and AUCBG and significant negative correlation with AUCINS. Conclusion： Glucagon and free fatty acid of T2DM and IGT patients increased, which was positively correlated wit

关 键 词：2型糖尿病 胰高血糖素 游离脂肪酸 血糖 胰岛素 

分 类 号：R587.1[医药卫生—内分泌]