经典1型糖尿病患者胰岛素抵抗的高胰岛素正葡萄糖钳夹研究

Evaluation of insulin resistance in type 1 diabetes with euglycemic-hyperinsulinemic clamp

目的应用高胰岛素正葡萄糖钳夹技术评价t型糖尿病（T1DM）患者胰岛素抵抗程度。方法选择新诊断T1DM患者8例，初诊未治2型糖尿病（T2DM）患者8例，均经2周胰岛素强化治疗后进行高胰岛素正葡萄糖钳夹检测胰岛素敏感性指数（ISI），并与正常糖耐量志愿者10例进行比较。结果T1DM组的年龄、BMI、空腹胰岛素（Fins）及空腹C-肽等各项参数显著低于正常对照组（P〈0．05），而腰臀比（WHR）、收缩压（SBP）、舒张压（DBP）、TC、TG、LDL—C、HDL-C均与正常对照组差异无统计学意义。T1DM组与T2DM组比较，年龄、BMI、WHR、Fins、空腹C-肽、SBP、TC、TG均显著低于T2DM组（P〈0．05）。正常对照组、T1DM组、T2DM组ISI分别为12．83±1．09、9．95±0．50、3．80±0．20，3组间ISI差异有统计学意义（P〈0．05）。结论高胰岛素正葡萄糖钳夹检测结果显示，T1DM患者的ISI显著低于正常人，但高于T2DM患者。

Objective To investigate insulin resistance in type 1 diabetes （T1DM） with euglycemic-hyperinsulinemic clamp. Methods Eight cases of newly diagnosed T1DM and 8 cases of newly diagnosed type 2 diabetes （T2DM） were selected. Their insulin sensitivity index （ISI） was evaluated with euglycemic-hyperinsulinemic clamp after 2 week insulin intensive treatment and compared with that of 10 healthy volunteers （normal control group, NC group）. Results Age, BMI, fasting insulin（ Fins）, fasting C-peptide in the T1DM group were significantly lower than those in the NC group, while waist-to-hip ratio （WHR） , systolic blood pressure（SBP） , diastolic blood pressure （DBP）, TC, TG, LDL-C, HDL-C were not significantly different between the TIDM and NC groups. Age, BMI, WHR, Fins, fasting C-peptide, SBP, TC, TG in the TtDM group were significantly lower than those in the T2DM group. The ISI of the NC, T1DM and T2DM groups were 12. 83 ± 1.09, 9. 95±0. 50, 3.80 ＋ 0. 20, respectively. There was significant difference among the three groups （ P 〈 0. 05 ）. Conclusion The ISI in T1DM was significantly lower than that in NC group, but higher than that in T2DM.