Objective To evaluate islet β cell response to intravenous glucagon(a non-glucose secretagogue)stimulation in diabetes mellitus.Methods Nineteen patients with type 1 diabetes(T1D)and 131 patients with type 2 diabetes...Objective To evaluate islet β cell response to intravenous glucagon(a non-glucose secretagogue)stimulation in diabetes mellitus.Methods Nineteen patients with type 1 diabetes(T1D)and 131 patients with type 2 diabetes(T2D)were recruited in this study.T2D patients were divided into two groups according to therapy:36 cases treated with insulin and 95 cases treated with diet or oral therapy.The serum C-peptide levels were determined at fasting and six minutes after intravenous injection of 1 mg of glucagon.Results Both fasting and 6-minute post-glucagon-stimulated C-peptide levels in T1D patients were significantly lower than those of T2D patients(0.76±0.36 ng/mL vs.1.81±0.78 ng/mL,P<0.05;0.88±0.42 ng/mL vs.3.68±0.98 ng/mL,P<0.05).In T1D patients,the C-peptide level after injection of glucagon was similar to the fasting level.In T2D,patients treated with diet or oral drug had a significantly greater fasting and stimulated C-peptide level than those patients received insulin therapy(2.45±0.93 ng/mL vs.1.61±0.68 ng/mL,P<0.05;5.26±1.24 ng/mL vs.2.15±0.76 ng/mL,P<0.05).The serum C-peptide level after glucagon stimulation was positively correlated with C-peptide levels at fasting in all three groups(r=0.76,P<0.05).Conclusions The 6-minute glucagon test is valuable in assessing the function of islet β cell in patients with diabetes mellitus.It is helpful for diagnosis and treatment of diabetes mellitus.展开更多
AIM: To investigate the characteristics of the progression of islet β cell function in Chinese latent autoimmune diabetes in adult (LADA) patients with glutamic acid decarboxylase antibody (GAD-Ab) positivity, and to...AIM: To investigate the characteristics of the progression of islet β cell function in Chinese latent autoimmune diabetes in adult (LADA) patients with glutamic acid decarboxylase antibody (GAD-Ab) positivity, and to explore the prognostic factors for β cell function. METHODS: Forty-five LADA patients with GAD-Ab positivity screened from phenotypic type 2 diabetic (T2DM) patients and 45 T2DM patients without GAD-Ab matched as controls were followed-up every 6 mo. Sixteen patients in LADA1 and T2DM1 groups respectively have been followed-up for 6 years, while 29 patients in LADA2 and T2DM2 groups respectively for only 1.5 years. GAD-Ab was determined by radioligand assay, and C-peptides (CP) by radioimmune assay.RESULTS: The percentage of patients whose fasting CP(FCP) decreased more than 50% compared with thebaseline reached to 25.0% at 1.5th year in LADA1 group, and FCP level decreased (395.8±71.5 vs 572.8±72.3 pmol/L, P＜0.05) at 2.5th year and continuously went down to the end of follow-up. No significant changes of the above parameters were found in T2DM1 group. The average decreased percentages of FCP per year in LADA and T2DM patients were 15.8% (4.0-91.0%) and 5.2% (-3.5 to 35.5%, P= 0.000) respectively. The index of GAD-Ab was negatively correlated with the FCP in LADA patients (rs= -0.483, P = 0.000). The decreased percentage of FCP per year in LADA patients were correlated with GAD-Ab index, body mass index (BMI) and age at onset (rs = 0.408, -0.301 and -0.523 respectively, P＜0.05). Moreover, GAD-Ab wasthe only risk factor for predicting βcell failure in LADA patients (B = 1.455, EXP (B) = 4.283, P = 0.023). CONCLUSION: The decreasing rate of islet β cell function in LADA, being highly heterogeneous, is three times that of T2DM patients. The titer of GAD-Ab is an important predictor for the progression of islet β cell function, and age at onset and BMI could also act as the predictors.展开更多
目的探讨运动与中药对糖尿病大鼠胰岛β细胞功能指数(isletβ-cell function index,HOMA-%β)、血糖及氧化应激状态的影响。方法 Wistar雄性大鼠60只,用小剂量链脲佐菌素加高脂饲料的方法建立糖尿病大鼠模型,观察运动、中药丹蛭降糖胶...目的探讨运动与中药对糖尿病大鼠胰岛β细胞功能指数(isletβ-cell function index,HOMA-%β)、血糖及氧化应激状态的影响。方法 Wistar雄性大鼠60只,用小剂量链脲佐菌素加高脂饲料的方法建立糖尿病大鼠模型,观察运动、中药丹蛭降糖胶囊及两者联用对糖尿病大鼠空腹血糖(FBG)、空腹血清胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、胰腺匀浆中的谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、丙二醛(MDA)的影响,并计算HOMA-%β,用多因素逐步回归分析探讨影响HOMA-%β的主要因素。结果与模型组比较,单纯运动或中药干预后,大鼠FBG、TG、TC、胰腺MDA均明显降低(P<0.05,P<0.01),HOMA-%β明显升高(P<0.01),运动组胰腺GSH-Px活性明显升高(P<0.01);运动与中药联用对FBG、TG、HOMA-%β、胰腺SOD、GSH-Px改变有协同作用(P<0.05)。FBG与胰腺SOD、GSH-Px呈显著负相关且有线性回归关系,HOMA-%β与FBG、TG、TC、胰腺MDA水平负相关,与胰腺SOD、GSH-Px水平正相关,且与FBG有线性回归关系。结论运动及丹蛭降糖胶囊可发挥协同作用,能明显改善糖脂代谢、提高胰腺抗氧化水平,从而减轻胰岛β细胞损伤。展开更多
文摘Objective To evaluate islet β cell response to intravenous glucagon(a non-glucose secretagogue)stimulation in diabetes mellitus.Methods Nineteen patients with type 1 diabetes(T1D)and 131 patients with type 2 diabetes(T2D)were recruited in this study.T2D patients were divided into two groups according to therapy:36 cases treated with insulin and 95 cases treated with diet or oral therapy.The serum C-peptide levels were determined at fasting and six minutes after intravenous injection of 1 mg of glucagon.Results Both fasting and 6-minute post-glucagon-stimulated C-peptide levels in T1D patients were significantly lower than those of T2D patients(0.76±0.36 ng/mL vs.1.81±0.78 ng/mL,P<0.05;0.88±0.42 ng/mL vs.3.68±0.98 ng/mL,P<0.05).In T1D patients,the C-peptide level after injection of glucagon was similar to the fasting level.In T2D,patients treated with diet or oral drug had a significantly greater fasting and stimulated C-peptide level than those patients received insulin therapy(2.45±0.93 ng/mL vs.1.61±0.68 ng/mL,P<0.05;5.26±1.24 ng/mL vs.2.15±0.76 ng/mL,P<0.05).The serum C-peptide level after glucagon stimulation was positively correlated with C-peptide levels at fasting in all three groups(r=0.76,P<0.05).Conclusions The 6-minute glucagon test is valuable in assessing the function of islet β cell in patients with diabetes mellitus.It is helpful for diagnosis and treatment of diabetes mellitus.
基金Supported by the National Natural Science Foundation of China,No. 39370343 the National Ministry of Health Youth Talents Foundation, No. Q9420 the Hunan Health Bureau Key Scientific Funds, No. 9736, 2001-Z04
文摘AIM: To investigate the characteristics of the progression of islet β cell function in Chinese latent autoimmune diabetes in adult (LADA) patients with glutamic acid decarboxylase antibody (GAD-Ab) positivity, and to explore the prognostic factors for β cell function. METHODS: Forty-five LADA patients with GAD-Ab positivity screened from phenotypic type 2 diabetic (T2DM) patients and 45 T2DM patients without GAD-Ab matched as controls were followed-up every 6 mo. Sixteen patients in LADA1 and T2DM1 groups respectively have been followed-up for 6 years, while 29 patients in LADA2 and T2DM2 groups respectively for only 1.5 years. GAD-Ab was determined by radioligand assay, and C-peptides (CP) by radioimmune assay.RESULTS: The percentage of patients whose fasting CP(FCP) decreased more than 50% compared with thebaseline reached to 25.0% at 1.5th year in LADA1 group, and FCP level decreased (395.8±71.5 vs 572.8±72.3 pmol/L, P＜0.05) at 2.5th year and continuously went down to the end of follow-up. No significant changes of the above parameters were found in T2DM1 group. The average decreased percentages of FCP per year in LADA and T2DM patients were 15.8% (4.0-91.0%) and 5.2% (-3.5 to 35.5%, P= 0.000) respectively. The index of GAD-Ab was negatively correlated with the FCP in LADA patients (rs= -0.483, P = 0.000). The decreased percentage of FCP per year in LADA patients were correlated with GAD-Ab index, body mass index (BMI) and age at onset (rs = 0.408, -0.301 and -0.523 respectively, P＜0.05). Moreover, GAD-Ab wasthe only risk factor for predicting βcell failure in LADA patients (B = 1.455, EXP (B) = 4.283, P = 0.023). CONCLUSION: The decreasing rate of islet β cell function in LADA, being highly heterogeneous, is three times that of T2DM patients. The titer of GAD-Ab is an important predictor for the progression of islet β cell function, and age at onset and BMI could also act as the predictors.
文摘目的探讨运动与中药对糖尿病大鼠胰岛β细胞功能指数(isletβ-cell function index,HOMA-%β)、血糖及氧化应激状态的影响。方法 Wistar雄性大鼠60只,用小剂量链脲佐菌素加高脂饲料的方法建立糖尿病大鼠模型,观察运动、中药丹蛭降糖胶囊及两者联用对糖尿病大鼠空腹血糖(FBG)、空腹血清胰岛素(FINS)、甘油三酯(TG)、总胆固醇(TC)、胰腺匀浆中的谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、丙二醛(MDA)的影响,并计算HOMA-%β,用多因素逐步回归分析探讨影响HOMA-%β的主要因素。结果与模型组比较,单纯运动或中药干预后,大鼠FBG、TG、TC、胰腺MDA均明显降低(P<0.05,P<0.01),HOMA-%β明显升高(P<0.01),运动组胰腺GSH-Px活性明显升高(P<0.01);运动与中药联用对FBG、TG、HOMA-%β、胰腺SOD、GSH-Px改变有协同作用(P<0.05)。FBG与胰腺SOD、GSH-Px呈显著负相关且有线性回归关系,HOMA-%β与FBG、TG、TC、胰腺MDA水平负相关,与胰腺SOD、GSH-Px水平正相关,且与FBG有线性回归关系。结论运动及丹蛭降糖胶囊可发挥协同作用,能明显改善糖脂代谢、提高胰腺抗氧化水平,从而减轻胰岛β细胞损伤。
