2型糖尿病、糖耐量减低者真胰岛素和胰岛素原的改变及其意义  

Clinical significance of true insulin and proinsulin in patients with type 2 diabetes mellitus

作　　者：田小平[1] 黄慧健[1] 黄海波[1] 何浩明[1] 

机构地区：[1]江苏省连云港市第一人民医院放免中心,222002

出　　处：《淮海医药》2004年第3期176-178,共3页Journal of Huaihai Medicine

摘　　要：目的　研究 2型糖尿病 (2 DM)、糖耐量减低 (IGT)者血清真胰岛素 (TI)、胰岛素原 (PI)和免疫活性胰岛素 (IRI)的变化及其意义。方法　测定 5 9例新诊的 2 DM患者、39例 IGT和 4 1例正常糖耐量 (NGT)者空腹和餐后的血清 TI、PI和 IRI,分析并比较胰岛激素指标在不同组间及糖负荷后的变化。结果　各肥胖亚组的 TI、PI和 IRI均高于非肥胖亚组 (P<0 .0 1 ) ;2 DM组餐后 1 h的 TI和 IRI低于 NGT的相应组 (P<0 .0 5 ) ,并低于 2 h的水平 ,TI释放呈早期分泌相降低和高峰延迟 ;空腹 PI在 2 DM组 >IGT>NGT(P<0 .0 5 ) ;2 DM、IGT的空腹 PI/ IRI高于 NGT组 (P<0 .0 5 )。结论　肥胖组者均有高胰岛素血症和高胰岛素原血症 ,2 DM和 IGT者亦有高胰岛素血症和高胰岛素原血症 (不成比例的胰岛素原升高 ) ,不成比例的胰岛素原升高是胰岛Objective To investigate the changes and clinical significance of serum true insulin(TI),proinsulin(PI) and immune reactive insulin(IRI) in patients with type 2 diabetes mellitus(2DM) and cases of impaired glucose tolerance(IGT).Methods TI,PI and IRI were detected in fasting,1 h and 2 h postprandial sera in 59 recent diagnosed patients with type 2 DM,39 cases of IGT and 41 cases of normal glucose tolerance(NGT).They were divided into obese subgroup and non obese subgroup based on their body mass index(BMI).Results TI,PI and IRI were significantly higher in obese subgroup than those in non obese subgroup( P <0.01).TI and IRI of 1 h postprandial values were significantly lower than those in corresponding groups ( P <0.05),and also lower than that of 2 h values.Fasting PI of 2 DM were significantly higher than that of IGT,and IGT higher than that of NGT.PI/IRI in type 2 DM were significantly higher than that in NGT group( P <0.05).Conclusion The obese subjects have hyperinsulinemia and hyperproinsulinemia,which are also found in patients with type 2 DM and ICG.The disproportionate proinsulinemia was one of the markers of impaired β cell secretion function.

关 键 词：2型糖尿病 糖耐量减低 真胰岛素 胰岛素原 血清 免疫活性胰岛素 

分 类 号：R587.1[医药卫生—内分泌]