糖尿病胰岛素受体活性的研究

INSULIN RECEPTORS IN DIABETES MELLITUS

为阐述胰岛素受体活性测定的临床意义，探讨糖尿病的发病机制，对４７例非胰岛素依赖型糖尿病（ＮＩＤＤＭ）、１７例胰岛素依赖型糖尿病（ＩＤＤＮ）及２８例正常对照者行红细胞胰岛素受体（ＩＲ）测定。结果表明：ＮＩＤＤＭ高亲和力ＩＲ及低亲和力ＩＲ均明显低于配对年龄的正常对照组，尤以尚未治疗的初诊ＮＩＤＤＭ为著，但无高胰岛素血症，表明ＩＲ降低系原发性缺陷，而非降调节机制所致。ＩＤＤＭ高亲和力及低亲和力ＩＲ则明显高于对应的正常对照组。经用外源性胰岛素治疗后，ＩＲ值明显下降，表明ＩＤＤＭ的ＩＲ升高系升调节机制所致，而非原发性ＩＲ缺陷。

We described the clinical significance of the measurement of insulin receptors and the mechanism of non insulin dependent diabetes mellitus (NIDDM). Changes in insulin receptor (IR) of red blood cells in 47 patients with NIDDM were compared with those of 28 normal controls. The levels of high and low affinity IR in the 47 patients with NIDDM were lower than those of normal controls and were prominent in untreated new NIDDM patients. Hyperinsulinemia was not found in these patients, indicating that the low IR is a primary defect not caused by the “down regulation” mechanism. In the IDDM patients the levels of high and low affinity IR were higher than those of the normal controls, but decreased markedly after insulin therapy, indicating that the “up regulation” is attributable to the high IR levels, other than the primary IR defect.