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目的探讨胰岛素(Ins)、胰升血糖素(Glu)和Ins/Glu比值与不同糖代谢状态的相关性。方法选取T2DM患者(T2DM组)81例、IGR患者(IGR组)35例及糖耐量正常(NGT组)者38名,均行75g OGTT或标准馒头餐试验,分别测定各时点血糖、Ins和Glu水平。结果各组FIns水平比较,差异无统计学意义(P>0.05)。T2DM组0.5hIns、1hIns水平低于NGT和IGR组,IGR组2hIns水平高于NGT组(P<0.01或P<0.05)。IGR组胰岛素曲线下面积(AUCi)较T2DM组升高(P<0.01)。除3h外,T2DM组空腹及糖负荷后各时点Glu水平均高于NGT组和IGR组。T2DM组AUCglu较NGT组和IGR组增大(P<0.05)。T2DM组空腹、0.5h及1hIns/Glu比值均低于NGT组和IGR组(P<0.05)。AUCglu与体重、WC、BMI、HbA1c、Scr及SUA水平呈正相关(P<0.01)。结论 Glu分泌紊乱是T2DM患者胰岛功能受损的重要表现。应用Ins/Glu比值能更好的反映胰岛α及β细胞功能异常情况。
Objective To investigate the relationship between Ins, Glu and Ins / Glu in different glycometabolism states. Methods Totally 81 T2DM patients (T2DM group), 35 patients with IGR group (IGR group) and 38 normal glucose tolerance group (NGT group) were enrolled in this study. Blood glucose, Ins and Glu level. Results There was no significant difference in FIns levels between groups (P> 0.05). The levels of 0.5hIns and 1hIns in T2DM group were lower than those in NGT and IGR group. The level of 2hIns in IGR group was higher than that in NGT group (P <0.01 or P <0.05). The area under the curve of insulin (IUC) in IGR group was higher than that in T2DM group (P <0.01). Except for 3h, Glu levels in T2DM group were significantly higher than those in NGT group and IGR group at each time point after fasting and glucose loading. AUCglu increased in T2DM group compared with NGT group and IGR group (P <0.05). Fasting T2DM group, 0.5h and 1hIns / Glu ratio were lower than NGT group and IGR group (P <0.05). AUCglu was positively correlated with body weight, WC, BMI, HbA1c, Scr and SUA (P <0.01). Conclusion Glu secretion disorder is an important manifestation of impaired islet function in T2DM patients. Application of Ins / Glu ratio can better reflect the islet α and β cell dysfunction.