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2型糖尿病 糖耐量低减及糖尿病患者亲属胰岛 细胞功能变化的研究 |
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han those in the non-obese subgroups in all 4 groups; (2)Subjects of IGT/IFG (Group C) had the highest levels of I and CP concentrations in the 4 groups. The I and CP concentrations of the diabetics (Group D) had a declining tendency compared with Group C, but the levels of the 3 hormones of Group D were still higher than those of group A and B respectively; (3)Either in the obese subgroups or in the non-obese subgroups, and either for the fasting or for the postprandial sera, the PI level was increased stepwisely from Group A→B→C→D; (4)Using PI/I or PI/CP ratio (%) as parameters, the diabetic group had the highest ratio of PI/I either in the obese or in the non-obese subgroup, and either in the fasting or the postprandial sera; (5)In the present study, the “disproportional” hyperproinsulinemia was defined when the calculated ratio of PI/I or PI/CP was higher than those of the control group by x±2s. The occurrence rate in the corresponding group of disproportional hyperproinsulinemia (for PI/I or PI/CP) of A, B, C, and D group were 6.1%、9.6%、27.3% and 61.7% or 10.2%、32.7%、30.3% and 44.4% respectively. Conclusion Disproportionately increased PI may be a part of the entity of β-cell dysfunction and might be one of the predictive markers of type 2 diabetes mellitus.
【Key words】 Diabetes mellitus, non-insulin-dependent; Insulin; C-peptide; Proinsulin
胰岛素抵抗和胰岛β细胞功能缺陷是2型糖尿病发病机制中的两个主要环节，并经常同时存在。至今对β细胞功能的了解是通过测定外周血中胰岛素或(及)C肽的浓度，加上若干刺激或抑制试验来获得的。但一般所用方法不够特异，受血中胰岛素原不同程度交叉反应的影响，故称为“免疫活性胰岛素”(IRI)和“免疫活性C肽”(IRC)〔1〕。80年代末逐渐广泛开展测定的胰岛素原及其中间代谢物，也是反映β细胞功能的重要指标。本研究的目的是采用特异性(或称为“真”、“完整”)的胰岛素(I)，特异性C肽(CP)及胰岛素原(PI)类的放射免疫分析(RIA)测定一批具有不同胰岛功能的对象，来分析上述三种激素的空腹及试餐后2小时血中测定值的变化趋势，并与国外报道相比较。
对象和方法
一、对象
共观察215例。均为20～70岁之成人。按病史和血糖〔按美国糖尿病学会(ADA)建议的新诊断标准并参照1985年WHO标准〔2〕〕，将对象分为4组。
A组：糖耐量正常(NGT)对照组49例，空腹血糖＜6.1 mmol/L或(及)口服75 g葡萄糖(或100 上一页 [1] [2] [3] 下一页
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