C肽和胰高血糖素测定对肝源性糖尿病的临床意义
Clinical significance of glucagon and C-peptide in patients with hepatogenic diabetes
罗玲 1吉丽 1王颖霞 2孙丹宁 3王海霞 4马丽辉 5芦璇 4宋春丽6
作者信息
- 1. 邯郸市第二医院 内一科,河北邯郸056001
- 2. 邯郸市中心医院内分泌一科,河北邯郸056000
- 3. 邯郸市钢铁集团有限责任公司职工医院检验科,河北邯郸056000
- 4. 河北省冀中能源峰峰集团总医院重症医学科,河北邯郸056200
- 5. 邯郸市中心医院医务科,河北邯郸056000
- 6. 石家庄市第三医院心内科,河北石家庄050000
- 折叠
摘要
目的 探讨C肽释放试验及胰高血糖素测定对肝源性糖尿病(HD)的临床意义.方法 对102例HD、95例2型糖尿病(T2DM)及110例正常对照者(NC)行葡萄糖耐量试验,测定不同时间点血糖、胰岛素、C肽及胰高血糖素水平.采用稳态模型法的胰岛β细胞功能(Homa-β)、同样方法的胰岛素抵抗指数(Homa-IR)及空腹血糖/空腹胰岛素(FPG/FINS)来评估胰岛素抵抗,用胰岛素敏感指数(ISI)评估胰岛素敏感性.结果 HD组FPG低于T2DM组(P＜0.05),胰岛素分泌呈高峰延迟型,60、120 min胰岛素及C肽高于T2DM组(P＜0.05).HD组Homa-β及ISI高于T2DM组,FPG/FINS低于T2DM组(P均＜0.05).T2DM组Homa-IR高于NC组,ISI低于NC组(P均＜0.05).HD组胰高血糖素水平高于NC组及T2DM组(P＜0.05),60 min达到高峰,180 min恢复正常.结论 C肽释放试验及胰高血糖素测定对鉴别HD有一定价值,对肝细胞损伤程度的判定及预后有一定的临床意义.
Abstract
Objective To explore the clinical significance of glucagon and C-peptide in the patients with hepatogenic diabetes (HD).Methods Oral glucose tolerance test (OGTT) was carried out on patients with HD (n =102,Group HD) and type 2 diabetes (T2DM) (n =95,Group T2DM) and on normal controls (n =! 10,Group NC).Plasma glucose,insulin,C-peptide and glucagon were measured.Homeostatic model assessment-β (HOMA-β) was used to evaluate islet beta cell function.HOMA-IR (insulin resistance) and fasting plasma glucose (FPG)/fasting insulin of serum (FINS) were used to assess insulin resistance.Insulin sensitivity index (ISI) was measured to assess insulin sensitivity.Results The FPG level of Group H-D was lower than that of Group T2DM (P ＜ 0.05).A delayed insulin peak was showed in Group HD whose insulin and C-peptide levels at 60-and 120 min were higher than that of Group T2DM (P ＜ 0.05).HOMA-β and ISI were higher and FPG/FINS was lower in Group HD than in Group T2DM (P ＜ 0.05).HOMA-IR was higher and ISI was lower in Group T2DM than in Group NC (P ＜ 0.05).The glucagon level of Group HD was higher than that of both Group T2DM and Group NC (P ＜ 0.05),and it reached its peak at 60 min and returned to original level after 180 min.Conclusion C-peptide release test,as well as the level of glucagon,play a key role in the diagnosis of hepatic diabetes and in the judgement of liver cirrhosis.
关键词
肝源性糖尿病/胰岛素抵抗/胰岛β细胞功能/胰高血糖素/C肽Key words
hepatogenic diabetes/insulin resistance/islet β cell function/glucagon/C-peptide引用本文复制引用
出版年
2013
NETL
NSTL
维普
万方数据