早期2型糖尿病患者血浆生长抑素、胰高血糖素样肽1和胰升糖素水平的变化

Changes of plasma somatostatin,glucagon-like peptide-1 and glucagon in patients with type 2 diabetes in early stage

目的观察早期2型糖尿病患者血浆生长抑素、胰高血糖素样肽1(GLP-1)和胰升糖素的动态变化。方法以早期糖尿病患者(糖尿病组,n=49)和健康对照者(对照组,n=21)作为研究对象。采用口服葡萄糖耐量试验(OGTT),分别于空腹和糖负荷后2 h,测定血浆生长抑素、GLP-1和胰升糖素水平,计算上升率并分析相关性。结果糖尿病组空腹和糖负荷后2 h的血浆生长抑素和GLP-1水平及空腹胰升糖素水平均显著低于对照组(P<0.05),且两组糖负荷后2 h的测定值均高于空腹值;糖尿病组血浆胰升糖素水平和生长抑素的上升率显著高于对照组(P<0.05),两组间血浆GLP-1水平的上升率比较差异无统计学意义(P>0.05)。糖尿病组血浆生长抑素水平的上升率与血浆GLP-1水平的上升率呈正相关(r=0.367,P=0.015)。结论生长抑素对GLP-1抑制减少可能是早期2型糖尿病患者的一种代偿反应;在2型糖尿病早期胰升糖素已有不适当的分泌增多,相比GLP-1,血糖和胰岛素在其中的作用更为重要。

Objective To investigate the changes of plasma somatostatin,glucagon-like peptide-1（GLP-1） and glucagon in patients with type 2 diabetes in early stage.Methods Forty-nine patients with diabetes in early stage（diabetes group） and 21 normal controls（control group） were selected.Oral glucose tolerance tests（OGTT） were performed,the fasting plasma somatostatin,GLP-1 and glucagon and those 2 h after glucose load were measured,the increase ratios were calculated,and the correlation was analysed.Results The fasting plasma somatostatin,GLP-1 and glucagon and plasma somatostatin and GLP-1 2 h after glucose load in diabetes group were significantly lower than those in control group（P0.05）,and plasma somatostatin,GLP-1 and glucagon 2 h after glucose load were higher than fasting ones in both groups.The increase ratios of plasma somatostatin and glucagon in diabetes group were significantly higher than those in control group（P0.05）,and there was no significant difference in the increase ratio of plasma GLP-1 between two groups（P0.05）.The increase ratio of plasma somatostatin was significantly positively related to that of plasma GLP-1 in diabetes group（r=0.367,P=0.015）.Conclusion The reduction of inhibition of somatostatin on GLP-1 may be the compensatory response in patients with type 2 diabetes in early stage.In the early stage of type 2 diabetes,improper increase of glucagon secretion has already existed,and plasma glucose and insulin may play a more important role than GLP-1.