初发2型糖尿病患者GLP-1水平变化对胰高血糖素及早相胰岛素分泌的影响

Effects of the change of GLP-1 level on glucagon and early phase insulin secretion in the patients with the newly diagnosed type 2 diabetes

目的探讨初发2型糖尿病(T2DM)患者血胰高血糖素样肽-1(GLP-1)对胰高血糖素及早相胰岛素分泌的影响。方法以新发T2DM患者(T2DM组)、健康体检者(对照组)为研究对象,采用标准馒头餐试验,观察空腹、进餐后30 min、120 min静脉血浆GLP-1动态变化及对血浆葡萄糖、胰高血糖素、胰岛素分泌的影响。结果初发T2DM组患者馒头餐各时点GLP-1水平均分别较对照组显著降低,差异有统计学意义(P<0.05),馒头餐后30 min、120 min胰岛素水平显著降低(P<0.05),但空腹胰岛素无明显差异(P>0.05);而胰高血糖素则较对照组各时点显著升高,差异有统计学意义(P<0.05)。初发T2DM组早相胰岛素分泌指数(ΔFINS30/ΔG30)显著低于对照组,差异有统计学意义(P<0.05)。结论初发T2DM患者存在GLP-1分泌减少,GLP-1缺乏可能是T2DM患者胰岛β细胞分泌缺乏及胰高血糖素分泌过多的重要因素。

Objective To explore the effects of the change of Glucagon-like peptide-1 level on glucagon and early phase insulin secretion in the patients with the newly diagnosed type 2 diabetes.Methods Patients with the newly diagnosed type 2 diabetes（T2DM group） and healthy volunteers（control group） were used as the research object,and the standardized bread meal test was used to observe effects of the dynamic changes of GLP-1 level at 0 min,30 min and 120 min on plasma glucose,glucagon and insulin secretion.Results The levels of GLP-1 at each time point in newly diagnosed T2DM group were significantly reduced compared with those of the control group respectively（P ＆lt; 0.05）;The levels of insulin at 30 min and 120 min were both significantly reduced compared with those of the control group respectively（P ＆lt; 0.05）,but the difference had no statistical significance at 0 min between two groups（P ＆gt; 0.05）;The levels of glucagon at each time point in newly diagnosed T2DM group were significantly higher than that of the control group（P ＆lt; 0.05）.The first-phase insulin secretion index of newly diagnosed T2DM group was significantly reduced compared with those of the control group（P ＆lt; 0.05）.Conclusion The levels of GLP-1 at each time point in newly diagnosed patients with type 2 diabetes mellitus were significantly reduced;GLP-1 dificiency might be the important factors of lack of islet beta cell secretion and insrease of glucagon secretion.