红细胞胰岛素受体分析法的改良及其初步应用

Modification of Analytical method for Insulin Receptor of Red Blood Cells and Its Preliminary Clinical Application

胰岛素受体（ＩＲ）异常导致胰岛素作用障碍，是Ⅱ型糖尿病（ＮＩＤＤＭ）发病中的一个主要因素。本文改良国内外人红细胞ＩＲ分析方法，并应用于ＮＩＤＤＭ临床实践，取得满意结果。方法学的平均批内变异系数为５．６６％，批间变异系数为１２．６７％。健康人２３名（年龄２９～７０岁），高亲和力ＩＲ位点数为２２４．４±８９．８位点／细胞，平衡解离常数Ｋｄ＝（５．７１±０．６５）×１０－１１ｍｏｌ／Ｌ；低亲和力ＩＲ位点数为２０４４．９±１８８．９位点／细胞，Ｋｄ＝（２．９６±０．２９）×１０－９ｍｏｌ／Ｌ。７９例ＮＩＤＤＭ患者（年龄２４～７２岁），高亲和力ＩＲ位点数为１８０．６±１０３．６位点／细胞（Ｐ＞０．０５），但Ｋｄ＝（８．９７±２．１４）×１０－１１ｍｏｌ／Ｌ（Ｐ＜０．０５）；低亲和力ＩＲ位点数为１２３７．０±４９５．１位点／细胞，Ｋｄ＝（６．４４±０．９８）×１０－９ｍｏｌ／Ｌ，均与正常组差异显著（Ｐ＜０．０１）．表明ＮＩＤＤＭ患者ＩＲ结合量下降，受体对胰岛素亲和力下降。

We developed a radioreceptor assay method for measurement of insulin binding activity of erythrocyte insulin receptor. Altogether 23 normal subjects aged 29￣70 ys and 79 patients with noninsulin dependent diabetes mellitus (NIDDM) aged 24￣72 ys were included in this study. The maximum of specific binding ratio of erythrocyte insulin receptor was 25. 7±5. 0%, while nonspecific binding ratio was only 4. 3±0. 3%. The within batch coefficient of variation was 5. 66%,and the between assay variation was 12. 67%. So the method was stable,reliable,practicable and easy to perform. Compared with the normal subjects,the insulin binding capacity of insulin receptor of patients with NIDDM and the affinity decreased. The capacity of high-affinity insulin receptor of normal group and NIDDM group were 224. 4±89. 8 and 180. 6±103. 6sites/cell(P>0. 05) ,Kd were (5. 71±0. 65) 10-11mol/ L and (8. 97±2. 14)X10-11 mol/L (P<0. 05) ,respectively. The capacity of low-affinity insulin receptor of two groups were 2044. 9±188. 9 sites/cell and 1237. 0±495. 1sites/cell (P <0. 01),Kd were (2. 96±0. 29)X10-9mol/L and (6. 44±0. 98)X10-9mol/L (P>0.01),respectively. It is suggested that the abnormality of insulin receptor leading to insulin resistance might be one of important factors in the pathogesis of NIDDM.