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真胰岛素测定在分析 细胞功能及胰岛素敏感性的意义初探 |
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杨静 黎明 吴从愿 宋爱玲 张葵
【摘要】 目的 探讨真胰岛素(True insulin, TI)测定在分析胰岛β细胞功能及胰岛素敏感性中的意义。方法 采用双位点夹心放大酶联免疫分析法(BA-ELISA)及其它方法对43例糖耐量正常者(NGT)、20例糖耐量低减者(IGT)及47例2型糖尿病(DM)患者进行血清TI等的测定，初步分析其胰岛β细胞功能及胰岛素敏感性。结果 肥胖的2型DM组血清空腹TI水平不高(P＞0.05)，而免疫反应性胰岛素(IRI)则明显升高(P＜0.01)，OGTT 30分钟TI水平明显低于NGT组(P＜0.01)。用TI计算胰岛素释放指数，NGT＞IGT＞2型DM；敏感指数，NGT与IGT均明显高于2型DM(P＜0.01)；而用IRI计算胰岛素释放指数和敏感指数仅在NGT与2型DM组间有显著差异(P＜0.01)。结论 2型DM患者的高胰岛素血症可能是高胰岛素原血症；TI测定较IRI更能确切地评价β细胞功能及胰岛素敏感性。
【关键词】 糖尿病，2型 真胰岛素 β细胞功能 胰岛素抵抗
Preliminary study of true insulin determination in evaluating β-cell function and insulin sensitivity
YANG Jing,LI Ming,WU Congyuan,et al.
Department of Endocrinology,PUMC Hospital,PUMC & CAMS,Beijing,100730
【Abstract】 Objective To study the value of true insulin (TI) determination in evaluating β-cell function and insulin sensitivity. Methods The levels of TI were determined by new BA-ELISA in 43 NGT, 20 IGT and 47 type 2 diabetes mellitus (DM) subjects, and the β-cell function and insulin sensitivity were evaluated. Results The fasting TI levels showed no significant difference (P＞0.05) among NGT, IGT and type 2 DM groups, but the immunoreactive insulin (IRI) increased significantly in type 2 DM patients as compared with NGT (P＜0.01). The insulin release index of TI decreased gradually from NGT to type 2 DM. While the insulin sensitivity index showed no significant difference between NGT and IGT, both groups had higher indices than type 2 DM (P＜0.01). However, both insulin release and insulin sensitivity index of IRI revealed a significant difference only between NGT and type 2 DM. Conclusion The hyperinsulinemia measured by RIA in type 2 DM could be in part due to hyperproinsulinemia. The determination of TI may have a greater accuracy than IRI in evaluating β-cell function and insulin sensitivity.
【Key words】 Diabetes mellitus, type 2 True insulin β-cell function Insul[1] [2] [3] 下一页
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