胰岛素慢速脉冲分泌波动检测技术的建立及临床应用

Establishment of method for analyzing ultradian oscillations of insulin secretionand its clinical application

目的建立研究胰岛素慢速脉冲分泌的分析方法,并观察胰岛素慢速脉冲的分布特征. 方法 10例正常体重、正常糖耐量的中年个体在混合餐情况下,每15 min取血一次,连续进行24h,测定各时点的血糖、胰岛素、C肽,分析胰岛素慢速脉冲的发生时间、幅值等参数的规律. 结果空腹胰岛素分泌率(94.6±22.6)pmol/min,24 h胰岛素分泌率(229.2±63.8)pmol/min.三餐后出现第一个胰岛素脉冲发生时间分别为餐后(45.1±14.1)、(40.5±12.3)、(39.0±16.1)min,最大脉冲幅度分别为(441.5±219.5)、(502.4±204.8)、(503.8±251.0)pmol/min.早餐后胰岛素脉冲数为2～3个,午餐、晚餐后均为3～4个,夜间可出现3～5个低幅脉冲,全天共出现12～15个.协同性分析示血糖-胰岛素分泌率脉冲协同率(86.4±9.3)%,胰岛素分泌率-血糖脉冲协同率(80.8±12.0)%.结论成功建立混合餐情况下胰岛素慢速脉冲研究分析方法;观察了慢速脉冲的发生次数、分布以及与血糖变化的协同性.

Objective To establish the method for analyzing ultradian oscillations of insulin secretion, and to study the characteristics of ultradian pulse distribution. Methods Ten middle-age subjects (normal weight, normal glucose tolerance) were recruited in the 24 h-study. Blood samples were taken every 15 min, and blood glucose, insulin, C-peptide of every time point were measured. Standard diet was used in the study. Parameters such as the time and amplitude of insulin pulse were calculated and analysed. Results The fasting insulin secretion rate (ISR) was (94.6±22.6)pmol/min,whiletheaverageISRin whole day was (229.2±63.8)pmol/min. The first pulse of insulin secretion responding to meals appeared (45.1±14.1)min after breakfast, (40.5±12.3)min after lunch and (39.0±16.1)min after dinner. The maximal amplitudes of insulin secretion pulse aftereachmealwere(441.5±219.5)pmol/min,(502.4±204.8)pmol/min, and (503.8±251.0)pmol/min. There were 12 to 15 insulin pulses within 24 hours: 2 to 3 pulses after breakfast, 3 to 4 after each lunch and dinner, and 3 to 5 pulses during the night with lower amplitude. Temporal association between oscillations in glucose and ISR was analyzed with the calculation of pulse concomitancy. The pulse concomitancy of glucose with ISR was (86.4±9.3)%, and that of ISR with glucose was (80.8±12.0)%. Conclusion The method for analyzing ultradian oscillations of insulin secretion is successfully established in Chinese. The number and distribution of ultradian oscillations of insulin secretion and pulse concomitancy are observed.