瑞格列奈在2型糖尿病β细胞功能评价中的应用

Application of repaglinide in estimating β-cell function of type 2 diabetes mellitus

目的:探讨瑞格列奈联合口服葡萄糖耐量-胰岛素释放试验在评价初诊2型糖尿病患者β细胞功能方面的价值。方法:35例初诊2型糖尿病患者,诊断时行口服葡萄糖耐量试验,分别于次日及规律治疗7 d后隔夜空腹状态下提前15 min口服2 mg瑞格列奈,再次行口服葡萄糖耐量试验,并分别定义为A,B,C组。各组均抽取空腹、30 min和120 min静脉血,测定血糖、真胰岛素及放射免疫性胰岛素,并计算真胰岛素/放射免疫性胰岛素值及早时相胰岛素分泌指数。结果:30 min时,3组真胰岛素差异有统计学意义(P<0.05);真胰岛素/放射免疫性胰岛素值C组>B组>A组(P<0.05);C,B组早时相胰岛素分泌指数均较A组显著增加(P<0.01)。结论:瑞格列奈能够显著增加早时相真胰岛素释放量及真胰岛素/放射免疫性胰岛素值;瑞格列奈联合口服葡萄糖耐量-胰岛素释放试验较常规口服葡萄糖耐量-胰岛素释放试验能够更加真实地反映初诊2型糖尿病患者胰岛β细胞分泌和储备功能。

Objective To evaluate the role of repaglinide combined with OG-IRT in estimating β-cell function of newly diagnosed type 2 diabetes mellitus.Methods OGTT was performed in 35 newly diagnosed type 2 diabetes mellitus patients when they were diagnosed.It was repeated 15 minutes after 2 mg repaglinide was taken on the second day＇s morning,and on the eighth day＇s morning after regular application of repaglinide for 7 days.They were defined as group A,B,and C respectively.All the groups were collected the blood sample before taking repaglinide and anhydrous dextrose,30 minutes and 120 minutes after taking anhydrous dextrose.Blood glucose was measured with glucose oxidase method,true insulin with ELISA and immunoreactive insulin with radioimmunoassay.The ratio of true insulin to immunoreactive insulin and insulin secrete index of early phase（ΔI30/ΔG30） were calculated.Results In 30 minutes,there were statistic differences in true insulin in 3 groups（P0.05）.The ratio of true insulin to immunoreactive insulin was group C group B group A（P0.05）.Calculated with true insulin or immunoreactive insulin,insulin secrete index of early phase in group C and group B increased,which showed a statistic significance compared with group A（P0.01）.Conclusion Repaglinide can increase true insulin and the ratio of true insulin to immunoreactive insulin of early phase of insulin release significantly.Repaglinide combined with OG-IRT may better reflect the reserve and secrete function of β-cell than routine OG-IRT in newly diagnosed type 2 diabetes mellitus.