摘要
目的 以那格列奈 (NG) 口服葡萄糖耐量试验 (OGTT)方法评估LADA患者及其一级亲属(FDR)胰岛 β细胞功能。 方法 9例正常人 1周内先后行NG OGTT、精氨酸刺激试验和普通OGTT ,测定各时点的胰岛素和血糖水平。观察NG OGTT中胰岛素净增值与血糖净增值的比值 (ΔI/ΔG)和精氨酸刺激试验中急性期胰岛素释放 (AIR)的相关性 ,比较NG OGTT和普通OGTT的差异和关联。 10例FDR行NG OGTT和普通OGTT ,LADA和 2型糖尿病 (DM)患者各 9例仅行NG OGTT ,比较 4组研究对象在NG OGTT中的早期相胰岛素释放和胰岛 β细胞储备功能 ,并用HOMA公式评估胰岛素抵抗。 结果 (1)NG OGTT中胰岛素释放速率 (IRR)最高点为糖负荷后 3 0min ,且该时点的ΔI3 0 /ΔG3 0 与精氨酸刺激试验的AIR呈正相关 (Rs =0 .674,P <0 .0 5 ) ;NG OGTT中各时点胰岛素曲线下面积和胰岛素释放倍增值均高于普通OGTT(均P <0 .0 1)。 (2 )LADAFDR在NG OGTT中ΔI3 0 /ΔG3 0 (2 3 .0± 13 .2 )mU/mmol和 3 0min处IRR (1.3± 0 .8)mU·L-1·min-1均低于正常 (P <0 .0 5 ) ,而HOMA IR指数高于正常 (2 .2± 0 .7vs 1.5± 0 .7,P <0 .0 5 )。 (3 )LADA和 2型DM患者的HOMA IR指数分别为 (2 .9± 0 .9和 5 .0± 3 .4) ,均高于正常 (1.5± 0 .7) (2型DM >LADA >
Objective To evaluate the islet β-cell function in patients with latent autoimmune diabetes in adults (LADA) and their first-degree relatives (FDR) by nateglinide (NG)-oral glucose tolerance test (OGTT). Methods NG-OGTT, arginine stimulation test and OGTT were performed in 9 healthy controls within one week and the levels of serum glucose and insulin were determined. The correlation between the ratio of Δinsulin/Δglucose (ΔI/ΔG)in NG-OGTT and acute insulin release (AIR) in arginine stimulation test, and the relationship between NG-OGTT and OGTT were investigated. NG-OGTT and OGTT were also performed in 10 FDR of LADA patients, and NG-OGTT in 9 LADA subjects and 9 type 2 diabetes (DM) patients. AIR and reserve of islet β-cell function were compared among the abovefourgroups.Insulinresistance(IR) was assessed by HOMA. Results (1)The peak point of insulin release rate (IRR) was 30 min after glucose load and the ΔI 30 /ΔG 30 in NG-OGTT was positively correlated with the AIR in arginine stimulation test (Rs=0.674, P<0.05). The area under the insulin curve (AUC) and the multiplying value of insulin in NG-OGTT were all significantly higher than those in OGTT (all P<0.01). (2)The ΔI 30 /ΔG 30 was (23.0±13.2)mU/mmol and the IRR at 30 min of time point was (1.3±0.8)mU·L -1 ·min -1 in FDR of LADA, both of which were lower than those of controls 〔(34.4±19.3)mU/mmol and (1.9±0.6)mU·L -1 ·min -1 , P<0.05 and P<0.01〕. The index of HOMA-IR in FDR of LADA was higher than that of controls (2.2±0.7 vs 1.5±0.7, P<0.05). (3) The indexes of HOMA-IR in LADA and type 2 DM patients, 2.9±0.9 and 5.0±3.4respectively,werehigherthanthat of controls (1.5±0.7) (type 2 DM>LADA>control, P<0.01 or P<0.001). The ΔI 30 /ΔG 30 , IRR and multiplying value of insulin in the two groups of patients were both lower that those of controls 〔ΔI 30 /ΔG 30 : LADA, type 2 DM and controls were (3.3±1.1, 6.1±2.2 and 34.4±10.0)mU/mmol respectively〕 (P<0.01 or P<0.001), whil
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2004年第5期408-412,共5页
Chinese Journal of Endocrinology and Metabolism
基金
国家"十五"科技攻关项目(2 0 0 1BA70 2B0 1)
湖南省科技厅(0 2SSY30 65)资助
美国礼来亚洲公司科研基金(72 82 /B5K GH 0 4 35)资助
关键词
LADA
NG
患者
正常
胰岛素
OGTT
一级亲属
释放速率
IR
关联
Nateglinide
Oral glucose tolerance test
Islet β cell function
Latent autoimmune diabetes in adults
First-degree relatives
