2型糖尿病患者胰岛素、真胰岛素、瘦素间的互调作用  

The Mutual Modulated Effects among Insulin?True Insulin and Leptin in Type 2 Diabetes Mellitus Patients

作　　者：张昭馥[1] 王苏苏[1] 彭朝胜[1] 马晓兵[1] 张宝和[1] 臧贵明[1] 曹悦鞍[1] 龙南展[1] 夏菁[1] 

机构地区：[1]海军总医院干三科,北京100037

出　　处：《海军总医院学报》2002年第4期199-202,共4页Journal of Naval General Hospital of PLA

摘　　要：目的　探讨 2型糖尿病患者血清免疫反应性胰岛素、真胰岛素、瘦素间相互调节作用。方法　分别用放免法和酶联免疫吸附测定法测定了 39例 2型糖尿病患者和 31例正常人免疫反应性胰岛素、真胰岛素和瘦素水平 ,计算三者间及其与胰岛素和真胰岛素敏感性指标的相关关系。结果　 2型糖尿病患者免疫反应性胰岛素较正常人明显增高 (P <0 0 5 ) ,真胰岛素、瘦素无明显变化 ,免疫反应性胰岛素 /真胰岛素明显增高 ,胰岛素敏感性下降。正常人免疫反应性胰岛素、真胰岛素、瘦素之间有很好的正相关关系 ,2型糖尿病患者三者间则完全无关 ,但它们均与免疫反应性胰岛素 /真胰岛素有很好的相关关系 (P <0 0 1)。正常人及肥胖糖尿病患者的免疫反应性胰岛素、瘦素均升高 ,真胰岛素正常。结论　 2型糖尿病患者存在着胰岛素抵抗、真胰岛素相对不足和胰岛素 瘦素轴的平衡失调。测定真胰岛素和免疫反应性胰岛素 /真胰岛素比只测定免疫反应性胰岛素更能确切地反映 β细胞功能 ,临床意义更大。Objective To investigate the potential association among serum immunoreactive insulin (IRI), true insulin (TI) and leptin of type 2 diabetes mellitus (DM) patients. Methods IRI were determined with radioimmunoassay, TI and Leptin were determined with specific BA ELISA in 39 type 2 DM patients and 31 healthy control subjects. Evaluated the correlations among IRI?TI?Leptin and the sensitivity of IRI and TI. Results The IRI concentration and the ratio of IRI/TI increased significantly in type 2 DM patients as compared with that in control subjects ( P <0.05), but the insulin sensitivity reduced and TI?Leptin showed no evident changes. Strongly positive correlations among IRI?TI and Leptin in control subjects were observed, while neither of IRI?TI or Leptin was correlated in type 2 DM patients, but showed close correlation with IRI/TI ( P <0.01). IRI and Leptin were all increased in obese type 2 DM patients and healthy control subjects, TI was keeping normal. Conclusion Type 2 DM patients presented insulin resistance, relative lack of TI and a imbalance of IRI TI Leptin axis. The determine actions insulin leptin axis, TI and IRI/TI ratio may greater accuracy than the determine action of IRI indicate the β cell function and have more clinical significance. Obesity is the main cause of insulin and Leptin resistance.\;

关 键 词：糖尿病 胰岛素 真胰岛素 瘦素 Β细胞功能 肥胖 

分 类 号：R587.1[医药卫生—内分泌]