摘要
目的探讨不同空腹血糖浓度2型糖尿病(T2DM)患者餐后胰岛素和C肽释放水平变化特点,了解糖尿病患者胰岛功能。方法选取2016年1月至2017年6月重庆医科大学附属南川区人民医院收治的T2DM患者492例,以T2DM患者空腹血糖(FPG)为依据分为A组[7.0mmol/L≤FPG<11.1mmol/L],B组(11.1mmol/L≤FPG<14.0mmol/L)和C组(FPG≥14.0mmol/L)。同时选取50例健康人作为对照组。各组在空腹时与口服75g无水葡萄糖后于0.5、1.0、2.0、3.0h分别采集静脉血2mL,采用化学发光方法测定其各点胰岛素和C肽水平,并分别与对照组进行比较。结果 T2DM患者空腹时胰岛素及C肽水平略高于对照组,差异无统计学意义(P>0.05)。进食后对照组与T2DM患者A、B、C 3组胰岛素、C肽水平均上升,对照组于餐后1.0h升至峰值,餐后3.0h逐渐恢复正常,而T2DM患者于餐后2.0h升至峰值,至餐后3.0h有所下降,但仍无法恢复至正常水平。T2DM患者A、B、C组在0.5、1.0、2.0h胰岛素、C肽水平均明显低于对照组,差异有统计学意义(P<0.05)。结论 T2DM患者胰岛β细胞功能随血糖升高而降低,测定胰岛素及C肽能够为临床判断病情严重程度及指导治疗提供科学依据。
ObjectiveTo investigate the changes of postprandial serum insulin and C-peptide concentration of type 2 diabetes mellitus(T2DM)patients with different fasting blood glucose concentrations,and to study the islet function of them.MethodsThere were 492 T2DM patients from January 2016 to June 2017 in our hospital were selected and divided into three groups according to different fasting plasma glucose(FPG)levels:group A,7.0 mmol/L≤FPG<11.1 mmol/L;group B,11.1 mmol/L≤FPG<14.0 mmol/L;group C,FPG≥14.0 mmol/L.Meanwhile,50 healthy examinees were collected as the control group.A standard 75 g OGTT were performed in 492 T2DM patients and 50 healthy controls,and 2 mL of venous blood of them were collected at 0.5,1.0,2.0 and 3.0 h.The concentration of insulin and C-peptide at each point was measured by chemiluminescence method,and then compared with the control group.ResultsThe concentration of insulin and C-peptide in T2DM patients were slightly higher than those in the control group,but there was no statistical significance(P>0.05).The serum insulin and C-peptide post-meal in the A,B and C groups and control group increased,but the 1.0 h postprandial blood glucose of control group increased to a peak,and gradually returned to normal at 3.0 h;the 2.0 h postprandial blood glucose of A,B and C groups increased to a peak,and decreased at 3.0 h,but did not return to normal level.The concentrations of insulin and C-peptide in the A,B and C groups at 0.5,1.0,and 2.0 h post-meal were significantly lower than those in the control group(P<0.05).ConclusionThe function of isletβcells in T2DM patients decreases with the increase of blood glucose.The determination of insulin and C-peptide can provide a scientific evidence for judging the severity of disease and guiding treatment.
作者
汪文明
丁正林
简芳
钟邦原
杨夕
WANG Wenming;DING Zhenglin;JIAN Fang;ZHONG Bangyuan;YANG Xi(Affiliated Nanchuan District People′s Hospital,Chongqing Medical University,Chongqing 408400,China;Chongqing Hongren First Hospital,Chongqing 408400,China)
出处
《国际检验医学杂志》
CAS
2019年第2期203-205,209,共4页
International Journal of Laboratory Medicine
基金
国家863计划子课题(2014AA022304)
