快速相胰岛素分泌功能的评价  

Evaluation of acute insulin release function

作　　者：包玉倩[1] 贾伟平[1] 朱敏[1] 陆俊茜[1] 陈蕾[1] 项坤三[1] 

机构地区：[1]上海交通大学附属第六人民医院内分泌代谢科,上海市糖尿病研究所200233

出　　处：《中华内分泌代谢杂志》2004年第2期129-131,共3页Chinese Journal of Endocrinology and Metabolism

基　　金：上海市科技发展基金 (0 1 4 1 1 90 1 2 );上海市医学发展基金重点研究课题项目〔0 1ZD0 0 2 (1 )〕

摘　　要：目的　 ( 1)研究正常糖耐量者应用高葡萄糖钳夹试验所形成的第一相胰岛素分泌功能 ( 1PH) (快速相胰岛素分泌 ) ,与口服葡萄糖耐量试验 (OGTT )、精氨酸刺激试验中反映早期胰岛素分泌功能指标的关系 ;( 2 )探讨评价胰岛 β细胞早期分泌功能的简易方法。 方法　对 2 8例正常体重、正常糖耐量的个体分别进行高葡萄糖钳夹试验、OGTT及精氨酸刺激试验。结果　 ( 1)OGTT 3 0min胰岛素、胰岛素净增值及胰岛素净增值与血糖净增值的比值与 1PH均无明显相关 ;( 2 )OGTT 10min胰岛素值 (r =0 .5 8,P <0 .0 1)及胰岛素净增值 (r =0 .45 ,P <0 .0 5 )、2 0min胰岛素值 (r =0 .42 ,P <0 .0 5 )及胰岛素净增值与血糖净增值的比值 (r =0 .49,P <0 .0 1) ,均分别与 1PH显著相关 ;( 3 )精氨酸刺激试验的结果与 1PH明显相关 (r =0 .5 2 ,P <0 .0 1)。结论　OGTT 10min胰岛素值及胰岛素净增值、2 0min胰岛素值及胰岛素净增值与血糖净增值的比值 ,以及精氨酸刺激试验的结果可作为估测机体快速相胰岛素分泌较为可靠的参数。Objective (1) To study the relationship between the first phase insulin release (1PH) (acute insulin release) of hyperglycemic clamp and the indices of the early phase insulin secretion of oral glucose tolerance test (OGTT) and arginine stimulation test in subjects with normal glucose tolerance. (2) To explore a simple method that may reflect the early phase insulin secretion of islet β cells. Methods Twenty-eight individuals with normal weight and normal glucose tolerance were included. Hyperglycemic clamp, OGTT and arginine stimulation test were performed. Results (1) The correlation of 1PH with insulin concentration, the net increment of insulin and its ratio to plasma glucose at 30 min during OGTT was not significant. (2) 1PH was significantly associated not only with insulin concentration and the net increment of insulin concentration at 10 min during OGTT (r=0.58, P<0.01; r=0.45, P<0.05 respectively), but also with insulin concentration and the ratio of the net increment of insulin to plasma glucose at 20 min during OGTT (r=0.42, P<0.05; r=0.49, P<0.01 respectively). (3) The result of arginine stimulation test was also related to 1PH (r=0.52, P<0.01). Conclusion The insulin concentrations at 10 and 20 min during OGTT, the net increment of insulin at 10 min during OGTT and the ratio of net increment of insulin to plasma glucose at 20 min during OGTT, as well as the index in the arginine stimulation test could be used as reliable parameters in evaluating the early phase insulin secretion.

关 键 词：高葡萄糖钳夹技术 口服糖耐量试验 精氨酸刺激试验 第一相胰岛素分泌 早期胰岛素分泌 糖尿病 肥胖 诊断标准 

分 类 号：R587[医药卫生—内分泌]