真胰岛素测定对胰岛β细胞功能和胰岛素抵抗的评价

Study of true insulin determinations in evaluating β cell function and insulin resistance

目的 探讨血清真胰岛素 (TI)与免疫反应性胰岛素 (IRI)在反映胰岛 β细胞功能和胰岛素抵抗 (IR)方面的不同。 方法 测定正常糖耐量 (NGT)组 (75例 )、糖耐量减低 (IGT)组 (43例 )和 2型糖尿病 (T2DM )组 (54例 )的TI(ELISA法 )和IRI(RIA法 )水平 ,计算胰岛 β细胞功能指数 (HOMA β)和IR指数 (HOMA IR)。 结果 (1 )HOMA βTI在IGT非肥胖组低于NGT非肥胖组 (P <0 0 5) ,T2DM非肥胖组低于NGT和IGT非肥胖组 (均P <0 0 1 ) ;在IGT和T2DM肥胖组低于NGT肥胖组 (均P <0 0 1 )。HOMA βIRI在IGT和T2DM非肥胖组低于NGT非肥胖组 (均P <0 0 5) ;在NGT、IGT和T2DM肥胖组之间无显著差异。(2 )HOMA IRTI和HOMA IRIRI在非肥胖组和肥胖组均显示T2DM有明显IR。结论 在反映胰岛 β细胞功能方面TI优于IRI,在反映IR方面TI与IRI有着相似的意义。

Objective To study the difference between true insulin (TI) and immunoreactive insulin (IRI) in evaluating β cell function and insulin resistance (IR).Methods The levels of serum TI and IRI were determined in 54 cases with type 2 diabetes mellitus (Group T2DM), 43 cases with impaired glucose tolerance (Group IGT) and 75 cases with normal glucose tolerance (Group NGT) with ELISA and RIA methods respectively. The insulin resistance index (HOMA-IR) and pancreatic β cell function index ( HOMA-β) were analyzed preliminarily.Results 1. HOMA-β TI in non-obese subgroup with IGT was lower than that in non-obese subgroup with NGT (P<0.05), and the HOMA-β TI in non-obese subgroup with T2DM was lower than that in non-obese subgroups with NGT and IGT (P<0.01). HOMA-β TI of obese subgroups with IGT and T2DM was lower than that in obese subgroup with NGT (P<0.01). HOMA-β IRI in non-obese subgroups with IGT and T2DM was lower than that in non-obese subgroup with NGT (P<0.05). There was not significant difference of HOMA-β IRI in obese subgroups of NGT, IGT and T2DM. 2. HOMA-β TI and HOMA-β IRI show that there was obvious IR in T2DM group no matter in non-obese subgroup or obese subgroup. Conclusions TI is better than IRI in evaluating β-cell function. TI is similar to IRI in evaluating insulin resistance.