DM2患者胰岛β细胞功能观察

Observation on Beta-cell Function in Patients with Type 2 Diabetic Patients

目的:观察2型糖尿病(DM2)患者胰岛β细胞功能,探讨DM2人群胰岛β细胞功能的变化及不同浓度葡萄糖对胰岛分泌功能的影响。方法:对172例糖尿病患者停用药物24h后,口服75g葡萄糖行葡萄糖耐量实验(OGTT)及胰岛素释放试验(IRT)。根据我院172例DM2患者入院治疗情况,按其空腹胰岛素水平分为空腹低值组(A组),空腹低值有峰组(B组),空腹中值组(C组),空腹高值组(D组)及30例正常对照组(N组)。计算早期胰岛素分泌功能指数(△I30/△G30),基础胰岛素分泌指数(HOMAβ),修正胰岛β细胞功能指数(MBCI)。分析各组胰岛功能指数的变化。结果:DM2各组胰岛素水平较正常人组差异有显著性意义(P<0.05)。DM2△I30/△G30在A、B组比较差异有统计学意义。MBCI在C、D组比较差异有统计学意义。HOMAβ在A、B及C、D组比较差异有统计学意义。△I30/△G30及HOMAβ在各组呈正相关。△I30/△G30及MBCI在各组均无相关性。结论:△I30/△G30、MBCI及HOMAβ可用于临床粗略评估胰岛β细胞功能,DM2患者在治疗前做IRT、OGTT对其诊断、治疗有重要的临床意义。

Objective To study the pancreatic islets β- cell function in type 2 diabitic patients through the changes of parameters of β-cell function and the effects of plasma glucose levels on insulin secretion function in subjects with different blood gluces levels. Methods A total of 172 patients with type 2 diabetes and 30 controls were enrolled to take oral 75g glucose tolerance test and insulin releasing test （TRT）. These patients were of four group based upon their fasting insulin levels group A fasting low insulin （ 〈 6.0μU/ml ） value without post-oral glucose peak group B fasting low value and with peak, group C with fasting insulin middle value （7 -20μU/ml） group D fasting high value （over 20μU/ml）. Early insulin seretion index （△I30/△G30）. Basic insulin secretion index （HOMA μ） and modified β- cell function index （MBCI） were calculated. Results Insulin levels in group A, B, C, D were significantly different from those of controls （P 〈0.05）. There were significant difference in （△I30/△G30） between group A and group B. There were significant difference in MBCI between group C and group D. There was significant difference in HOMA β between group A and group B as well as between group C and group D. The △I30/△G30 was positively correlated with HOMA β in all groups however, △I30/△G30 was not correlated with MBCI. Conclusion △I30/△G30, MBCI and HOMA β may be used to evaluate β - cell function. Both the insulin release test and glucose tolerance test should be performed before treatment in patients with type 2 diabetes mellitus.