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胰岛素抵抗体内检测方法的探讨 |
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李芳萍 程桦 傅祖植 杨桂芳 刘顺莲
【摘要】 目的 探讨几种常用胰岛素抵抗 (IR) 体内检测方法的优缺点，并试图进行改良。方法 分别用三种最小模型技术（MMT），三种基础状态法，四种口服葡萄糖耐量试验（OGTT）法对16例葡萄糖耐量正常(NGT)者和13例非胰岛素依赖型糖尿病（NIDDM）病人计算胰岛素敏感性指数（ISI），并以经典MMT得出的ISI为标准，其余方法得出ISI与之进行比较和相关分析。结果 除空腹血糖、空腹胰岛素比值(FSG/FIns)和OGTT葡萄糖、胰岛素曲线下面积比值(AUCg/AUCi)作为ISI外，其余方法得出的 ISI均显示NGT 组高于NIDDM组（P<0.05, ISI相对值为1 和0.44～0.70），与经典MMT得出的ISI相关性强（r=0.45～0.92,P<0.05）。结论 MMT取血时间点数减至10～12个，时间缩至120分钟是可行的。李光伟提出的基础状态法和自我平衡模型分析法是同效的，均非常简单，可粗略评估IR。Cederholm 的OGTT法是一种简便、能正确评估IR的方法。本研究提出的两种OGTT法可能是较准确评估IR的方法。FSG/FIns和AUCg/AUCi作为ISI均不是可靠的检测IR方法。
【关键词】 糖尿病，非胰岛素依赖型 胰岛素敏感性指数
A methodological study on the evaluation of insulin resistance in vivo LI Fangping,CHENG Hua, FU Zuzhi, et al. Department of Endocrinology, The SUN Yatsen Medical Hospital of SUN Yatsen University of Medical Sciences, Guangzhou 510120
【Abstract】 Objective To investigate the advantage and disadvantage of several methods often used to evaluate insulin resistance and to attempt to modify the disadvantage. Methods Three protocols of minimal model technique (MMT), three protocols of basal state approach and four protocols of oral glucose tolerance test (OGTT) were used respectively to calculate insulin sensitivity index (ISI) in 16 subjects with normal glucose tolerance (NGT) and 13 patients with non-insulin-dependent diabetes mellitus (NIDDM) . ISI of classical MMT was regarded as standard ; ISI of other protocols were analyzed, assessed and compared with that of classical MMT. Results Except the ISI expressed by the ratio of fasting serum glucose to insulin concentration (FSG/FIns)and the ratio between area under curve (AUC) of glucose and insulin (AUCg/AUCi) in OGTT, ISI of other protocols was signifi-cantly higher in NGT group than in NIDDM group (P<0.05, ISI relative values were 1 and 0.44～0.70 respectively) and had stronger relationships as compared with ISI of classical MMT (r=0.45～0.92, P<0.05). Conclusion The modifications that reduce the sa[1] [2] [3] 下一页
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