胰岛素脉冲式分泌及其临床意义

• 作 者: 李明珍
• 机 构: 天津医科大学代谢病医院 天津 300070
• 出 处: 国外医学(内分泌学分册)
• 发表日期: 2003年04期
• 关键词: 脉冲式分泌 胰岛素抵抗 胰岛素分泌 磺脲类药物 胰升糖素 神经体液因子 葡萄糖代谢 细胞功能受损 格列奇特 胰岛素释放

生理状态下胰岛素分泌呈现脉冲方式,参与其分泌调节的途径一是葡萄糖调节,即K_(ATP)通道依赖的触发通路;二是非K_(ATP)通道依赖的扩大效应通路,两条途径协调作用。其调节机制目前认为与Ca~(2+)浓度的变化规律相关,同时一些神经体液因子也参与了脉冲式分泌的体内调节。而2型糖尿病者的脉冲分泌出现异常,予以减轻体重、磺脲类药物、胰升糖素样肽-1等干预,可以改善胰岛素的脉冲式分泌。

Under physiological conditions, insulin secretion appears in a pulsating manner, and one of the pathways involved in its secretion regulation is glucose regulation, that is, K (ATP) channel-dependent trigger pathway; and second, non-K ATP channel-dependent expansion effect pathway. At present, the regulation mechanism is related to the variation of Ca 2+ concentration, and some neurohumoral factors are also involved in the regulation of impulsive secretion in vivo. The type 2 diabetes, abnormal pulse secretion, to reduce weight, sulfonylurea, glucagon-like peptide-1 and other interventions, can improve the pulse of insulin secretion.