检验医学 ›› 2013, Vol. 28 ›› Issue (5): 366-369.DOI: 10.3969/j.issn.1673-8640.2013.05.005

• 临床应用研究.论著 • 上一篇    下一篇

2型糖尿病患者高胰岛素血症变化的研究

李莎1,刘蕊2,吴谊青3,吴丽娜4   

  1. 1. 天津医科大学,天津 300070; 2. 天津市人民医院,天津 300121
  • 收稿日期:2012-09-19 修回日期:2012-11-28 出版日期:2013-05-15 发布日期:2013-05-14
  • 通讯作者: 刘蕊,联系电话:022-27557453。
  • 作者简介:李莎,女,1987年生,学士,主要从事糖尿病与结直肠癌发生风险性研究。

Study of hyperinsulinism progression in patients with type 2 diabetes mellitus

  1. 1.Tianjin Medical University,Tianjin 300070,China; 2.Tianjin People′s Hospital,Tianjin 300121,China
  • Received:2012-09-19 Revised:2012-11-28 Online:2013-05-15 Published:2013-05-14

摘要: 摘要: 目的 探讨2型糖尿病(T2DM)不同发展阶段高胰岛素血症(HINS)的变化情况。 方法 分别检测38例T2DM前期、52例新确诊、92例有T2DM病史患者(按病程分为0.5~3年、4~7年和8~11年)及20名正常对照者糖化血红蛋白(HbA1c)、血糖、胰岛素、C肽等指标,并采用从www.ocdem.ox.ac.uk下载的HOMA2计算器(V2.2)计算胰岛素抵抗指数(HOMA2-IR)和胰岛素分泌指数(HOMA2-%β)。 结果 T2DM各组胰岛素分泌高峰出现在2 h,均呈现胰岛素分泌延迟现象;T2DM前期组和新确诊组口服葡糖糖耐量试验(OGTT) 2 h胰岛素均值高于HINS诊断标准,且HINS患者分别占各组的50.00%和48.10%;随着病程的增长,HINS患者在有0.5~3年、4~7年和8~11年T2DM病史的患者中分别占28.57%、13.89%和10.00%。 结论 T2DM前期有相当一部分患者处于HINS状态;随着病程的增长,HINS患者逐渐减少,但仍有部分T2DM患者长期处于HINS状态。

关键词: 高胰岛素血症, 胰岛功能, 糖尿病, 2型

Abstract: Objective To investigate the progression of hyperinsulinism(HINS) in different development phases of type 2 diabetes mellitus (T2DM).  Methods A total of 38 pre-T2DM patients,52 newly diagnosed T2DM patients and 92 patients who had T2DM history were enrolled. According to the course of T2DM,the patients with T2DM history were classified into 3 groups:0.5-3 years,4-7 years and 8-11 years, and 20 healthy subjects were as controls. The glycosylated hemoglobin (HbA1c),blood glucose,insulin and C peptide were determined.Homeostasis model of insulin resistance index(HOMA2-IR) and secretion function index (HOMA2-%β) were calculated by HOMA2 calculator (V2.2) downloaded from www.ocdem. ox.ac.uk.  Results All T2DM groups′ secretion peaks appeared in 2 h of oral glucose tolerance test(OGTT), and all presented secretion delay. The 2 h insulin levels of the pre-T2DM and newly diagnosed T2DM groups were higher than HINS diagnosis standard,and the HINS patients accounted for 50.00% and 48.10%, respectively. With the increasing of T2DM course,the proportions of HINS patients in the T2DM history group were 28.57%,13.89% and 10.00%, respectively.  Conclusions There is a proportion of pre-T2DM patients with HINS,and with the increasing of T2DM course,the proportion of HINS patients reduces,but HINS still exists in patients with long history of T2DM.

Key words: Hyperinsulinism, Pancreatic function, Diabetes mellitus, type 2