不同糖耐量人群尿C肽肌酐比值与胰岛β细胞功能和胰岛素抵抗的关系研究  

Correlation of Urinary C Peptide/Creatinine Ratio with Islet β Cell Function and Insulin Resistance in the Population with Different Glucose Tolerance

作　　者：高婷婷[1] 

机构地区：[1]滁州市第一人民医院,安徽滁州239000

出　　处：《北华大学学报（自然科学版）》2017年第3期352-355,共4页Journal of Beihua University（Natural Science）

基　　金：安徽省科技攻关计划项目(1501041157)

摘　　要：目的探讨不同糖耐量人群尿C肽肌酐比值与胰岛β细胞功能和胰岛素抵抗的关系.方法选取内分泌科就诊患者,根据75 g葡萄糖耐量检查结果分为正常糖耐量组72例,糖调节受损组54例,Ⅱ型糖尿病组94例.行静脉葡萄糖耐量实验,检测0~10 min胰岛素水平,计算急性胰岛素反应(AIR3-5)、0~10 min胰岛素曲线下面积(AUC)、稳态模型胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β);留取受试者清晨空腹第1次、第2次尿液样和24 h尿样本,酶法检测尿肌酐值,化学发光法检测C肽水平,计算C肽肌酐比值.结果糖调节受损组、Ⅱ型糖尿病组空腹血糖、餐后2 h血糖、空腹胰岛素、餐后2 h胰岛素、糖化血红蛋白、HOMA-IR均明显高于正常糖耐量组,差异具有统计学意义(P<0.05);而肾小球滤过率在3组间差异无统计学意义(P>0.05).糖调节受损组、Ⅱ型糖尿病组AIR3-5、AUC、HOMA-β、第1次尿C肽肌酐比值、第2次尿C肽肌酐比值、24 h尿C肽明显高于正常糖耐量组,差异具有统计学意义(P<0.05).第1次和第2次尿C肽/尿肌酐比值与AIR3-5,AUC,HOMA-β呈负相关,与HOMA-IR呈正相关,其中以第2次C肽尿肌酐比值相关性最佳.结论尿C肽肌酐比值在Ⅱ型糖尿病及糖调节受损个体中明显升高,且与胰岛β细胞第一时相分泌功能、胰岛素抵抗有直接相关性.Objective To investigate the correlation of urinary C peptide/ereatinine ratio with islet β cell function and insulin resistance in the population with different glucose tolerance. Method According to 75 g glucose tolerance test results,the clients were divided into 2 groups：normal glucose tolerance group （n = 72） , impaired glucose regulation group （ n= 54 ）, and type 2 diabetes mellitus group （ n = 94 ）. Intravenous glucose tolerance test was conducted,0 -10 rain insulin levels were detected, and acute insulin response （AIR3-5） ,0 10 min area under the curve of insulin （AUC） ,insulin resistance index （HOMA-IR） and islet beta cell function index （HOMA-β） were caleulated; the subjects＇ urine samples at the first time and the second time in the morning,and those at 24 h were taken, and the urine creatinine values were measured by enzyme method,the Cpeptide levels were detected by chemiluminescence and C peptide/creatinine ratios were calculated. Results Fasting blood glucose,2 h postprandial blood glucose, fasting insulin, postprandial insulin, glycosylated hemoglobin and 2 h HOMA-IR in both IGR group and type 2 diabetes group were significantly higher than those in normal glucose tolerance group （P 〈 0.05 ）, while the difference in the glomerular filtration rate was not significant among of the three groups （ P 〉 0.05 ）. AIR3-5, AUC, HOMA-β, first urinary C peptide/creatinine ratio, second urinary C peptide/creatinine ratio and 24 h urine C peptide in IGR group and type 2 diabetes group were significantly higher than those in normal glucose tolerance group （ P〈0.05 ）. The first and second urinary C peptide/creatinine ratios were negatively correlated with AIR3-5, AUC, HOMA-β, and was positively correlated with HOMA-IR, among which the correlation of the ratio with the second C peptide/urinary creatinine was the best. Coneltmion The ratio of urinary C peptide/creatinine was significantly increased in patients with type 2 diabetes mellitus and impaired glucose r

关 键 词：糖耐量 尿C肽肌酐比值 胰岛Β细胞 胰岛素抵抗 

分 类 号：R587[医药卫生—内分泌]