1型糖尿病病人胰高血糖素和C-肽水平变化及意义

CHANGES AND CLINICAL SIGNIFICANCE OF GLUCAGON AND C-PEPTIDE LEVELS IN TYPE 1 DIABETES

目的探讨1型糖尿病(T1DM)病人C肽兴奋试验过程中血浆胰高血糖素(Gg)、血清C-肽含量的变化及意义。方法分别采用酶联免疫吸附法、电化学发光法,检测42例T1DM病人空腹及馒头餐后血浆Gg、血清C-肽水平,并与35例健康人(对照组)进行比较。结果 T1DM病人Gg水平、Gg总释放量均显著高于对照组(Z=2.708、2.967,P<0.01)。T1DM病人空腹和馒头餐后C-肽水平、C-肽总释放量均显著低于对照组(Z=5.983～6.203,P<0.01)。结论 T1DM病人存在显著的胰岛B细胞功能障碍及胰岛A细胞功能异常;针对胰岛A细胞的靶向治疗可能是治疗T1DM的一个新方向。

Objective To study the plasma glucagon and serum C-peptide in type 1 diabetes （T1DM） in C-peptide stimu- lation test. Methods The fasting and postprandial plasma levels of glucagon and serum C-peptide were detected in 42 patients with T1DM by enzyme-linked immunosorbent assay and electrochemilumineseence method, respectively, the results were com- pared with 35 normal controls. Results The level and total releasing volume of glucagon in the patients were higher than the normal controls （Z = 2.708,2.967;P 〈0.01） ; the level of fasting and postprandial C-peptide and total releasing volume of C-peptide in the patients were lower than the controls （Z=5.983--6.203;P〈0.01）. Conclusion There is an obvious insular-B-cell and A- cell dysfunction in type 1 diabetes; a targeted therapy aiming directly at insular A cells may be a new direction for the treatment of this condition.