摘要
目的探讨精氨酸刺激试验及静脉葡萄糖耐量试验、口服葡萄糖耐量试验评估不同糖耐量人群的胰岛β细胞功能的价值。方法横断面选取2003年1月至2007年6月中山大学附属第二医院内分泌科无糖尿病家族史的正常糖耐量（NGTFH-）者38名、有糖尿病家族史的正常糖耐量（NGTFH＋）者32名、无糖尿病家族史的糖调节受损（IGRFH-）者31例、有糖尿病家族史的糖调节受损（IGRFH＋）者36例及新诊断的2型糖尿病（T2DM）患者35例参与本试验，均行精氨酸刺激试验、静脉葡萄糖耐量试验和口服葡萄糖耐量试验。计算精氨酸刺激后急性C肽反应（ACR_ARC），第一时相胰岛素分泌功能指数（AIR_0-10）、早期胰岛素分泌功能指数（△I_30／AG_30），分析不同糖耐量人群各胰岛B细胞功能指数的变化。结果①ACR_ARC5组间比较差异均无统计学意义。②AIR_0-10：T2DM组低于其余4组，差异均有统计学意义（均P〈0．01）；IGRFH＋组与IGRFH-组比较差异无统计学意义，而低于NGTFH＋及NGTFH-组，差异均有统计学意义（均P〈0．01）；IGRFH-组低于NGTFH＋及NGTFH-组，差异有统计学意义（P〈0．05，〈0．01）；NGTFH＋组低于NGTFH一组，差异均有统计学意义[50．0（24．3-85．1）比69．4（46．1-4．8），P〈0．05]。③△I_30／△G_30：T2DM组与IGRFH＋组比较差异无统计学意义，而低于其余3组，差异均有统计学意义（均P〈0．01）；IGRFH＋组及IGRFH-组均低于NGTFH＋及NGTFH-组，差异均有统计学意义（均P〈0．01）；有或无家族史的IGR及NGT组间比较差异均无统计学意义。结论精氨酸刺激试验测定的c肽增值不适用于评估糖尿病早期、糖调节受损及糖尿病高危人群的早期时相胰岛功能变化。
Objective To explore the values of arginine stimulation, oral glucose-insulin release and intravenous glucose tolerance tests to assess the function of islet β-cell in individuals with differential glucose tolerance. Methods Healthy subjects （ n = 38 ） and those with impaired glucose regulation （IGR） without a family history of diabetes （ n = 31 ）, 32 normal glucose tolerance （ NGT, n = 32） and impaired glucose regulation as first-degree relatives of type 2 diabetes mellitus （DM） （ IGR, n = 36 ） and 35 newly- diagnosed type 2 DM （ n = 35 ） were recruited. All of them received arginine C-peptide releasing test （AST）, oral glucose-insulin release test （OG-IRT） and intravenous glucose tolerance test （IVGTT）. ACRARG was used to reflect non-glucose stimulated insulin secretion function, AIR_0-10 for first-phase insulin secretion function and △I_30/△G_30 for early insulin secretion function. The changes of islet-B-cell function indicators were detected in individuals with different glucose tolerance. Results ① No significant differences existed in ACRARG among five groups （ all P 〉 0. 05 ）. ② In terms of AIR_0-10, the patients of type 2 DM had lower levels than those with IGR and NGT with or without a family history of DM（ all P 〈 0.01 ）. No significant difference existed among the subjects of IGR regardless of a family history of DM（P 〉 0. 05）. However, the subjects of IGR with or without a family history of DM had lower levels than those with NGT regardless of a family history of DM（P 〈0. 01 or P 〈0. 05）. The subjects of NGT with a family history of DM had lower levels than those with NGT without a family history of DM （ 50. 0 （ 24. 3 - 85.1 ） vs 69.4（46. 1 -94. 8）,P 〈 0. 05）. ③△I_30/△G_30 ： no significant difference existed between the patients of type 2 DM and IGT with a family history of DM （ P 〉 0. 05 ）. However, the subjects of type 2 DM had lower levels than those of IGR without a family history of DM and NGT with or without a family history of DM （ all P 〈 0. 01 ）. The subjects of IGR with or without a family history of DM had lower levels than those with NGT regardless of a family history of DM（all P 〈0. 01 ）. No significant difference existed among the subjects of NGT with or without a family history of DM （ P 〉 0. 05 ）. And it was the same with IGR group. Conclusion The acute C-peptide response to arginine stimulation test may not be used to evaluate the early phase insulin secretion among the subjects of early- stage DM, impaired glucose regulation and high diabetic risks.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第10期760-763,共4页
National Medical Journal of China
关键词
胰岛
糖尿病
2型
葡糖耐量试验
精氨酸刺激试验
Isiets of langerhans
Diabetes mellitus, type 2
Glucose tolerance test
Argininestimulation test
