精氨酸负荷实验对糖尿病性血管病变病人胰岛素和胰高糖素水平的影响

THE EFFECTS OF L-ARG TEST ON INSULIN AND GLUCAGON LEVELS IN PATIENTS WITH DIABETIC ANGIOPATHY

1目的 探讨 2型糖尿病并发慢性血管病变病人胰岛素和胰高糖素水平的变化及意义。 2方法 采用放射免疫法分别检测了 85例病人空腹及左旋精氨酸 (L - ARG)刺激后 2 ,4,6 m in时的胰岛素 (INS)、胰高糖素水平的变化 ,并与 6 0例健康人进行对照。 3结果 2型糖尿病并发血管病变组空腹胰岛素及胰高糖素水平明显高于对照组和无血管病变组 (F=8.6 5 ,10 .6 5 ,q=3.72～ 6 .48,P<0 .0 5 ,0 .0 1) ;L - ARG刺激后对照组和 2型糖尿病组INS和胰高糖素分泌均在 2 min时达峰值 ,2型糖尿病并发血管病变组 2 min时的 INS分泌值及 2 ,4min时的胰高糖素分泌值均明显高于无血管病变组 (F =4.93～ 73.6 7,q=3.0 2～ 4.97,P<0 .0 5 ,0 .0 1) ;2型糖尿病并发血管病变组空腹 INS及峰值 INS水平分别与空腹及峰值胰高糖素水平呈正相关 (r=0 .5 33,0 .6 19,P均 <0 .0 0 1)。 4结论有血管病变的 2型糖尿病病人存在明显的胰岛素抵抗 (IR)和高胰高糖素血症 ;IR及高胰高糖素血症与糖尿病性血管病变的发生、发展有密切关系。

Objective To investigate the changes of serum insulin (INS) and glucagon levels and their significance in patients with diabetic angiopathy. Methods The changes of serum INS and glucagon levels in 85 patients with type 2 diabetes mellitus at fasting time and 2, 4, 6 min after being injected L ARG were respectively measured with radioimmunoassay. 60 health subjects were as controls. Results The fasting INS and glucagon levels in patients with diabetic angiopathy were significantly higher than those in controls and diabetics without angiopathy (F=8.65,10.65,q=3.72-6.48,P<0.05,0.01). The INS levels at 2 min and the Glucagon levels at 2,4 min after injected L ARG were significantly higher in the patients with diabetic angiopathy than those in the patients with non angiopathy (F=4.93-73.67,q=3.02-4.97,P<0.05,0.01). The levels of fasting INS and the maximal INS after L ARG injection were positively correlated with the levels of fasting and the maximal Glucagon respectively in patients with diabetic angiopathy(r=0.533,0.619,P<0.001).\ Conclusion There is significant insulin resistance(IR) and hyperglucagonemia in patients with diabetic angiopathy. IR and hyperglucagonemia may be closely related to the occurrence and development of diabetic angiopathies. [