Grill V, Dinesen B, Carlsson S, Efendic S, Pedersen O, Ostenson C-G
Department of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
Am J Epidemiol. 2002 May 1;155(9):834-41. doi: 10.1093/aje/155.9.834.
Elevated proinsulin and proinsulin/insulin ratios are features of abnormal beta-cell function in type 2 diabetes. The participation of genetic factors is disputed. The authors wished to investigate relations between family history of diabetes on one hand and proinsulin as well as proinsulin/immunoreactive insulin ratios on the other. A large, population-based sample of Swedish men aged 35-54 years in 1992 was studied. Subjects without known diabetes were selected either to have a strong family history of diabetes (n = 1,619) or no history of the disease (n = 1,495). An oral glucose tolerance test detected 172 subjects with impaired glucose tolerance and 55 subjects with previously unknown diabetes according to World Health Organization 1985 criteria. In multiple regression analysis, fasting levels of proinsulin and proinsulin/insulin ratios were positively associated both with the 2-hour glucose level (as a continuous variable) and with obesity, whereas a negative association was found with birth weight. No association was found with family history of diabetes or with chronologic age. These findings indicate that elevated proinsulin and proinsulin/insulin ratios are secondary to increased demands on beta-cell secretion induced by hyperglycemia and insulin resistance with no discernible influence of family history of diabetes.
胰岛素原及胰岛素原/胰岛素比值升高是2型糖尿病β细胞功能异常的特征。遗传因素的参与存在争议。作者希望一方面研究糖尿病家族史与另一方面胰岛素原以及胰岛素原/免疫反应性胰岛素比值之间的关系。1992年对瑞典35至54岁的大量男性人群样本进行了研究。选择无已知糖尿病的受试者，一部分有强烈的糖尿病家族史（n = 1619），另一部分无该病家族史（n = 1495）。根据世界卫生组织1985年标准，口服葡萄糖耐量试验检测出172名糖耐量受损受试者和55名既往未知糖尿病受试者。在多元回归分析中，胰岛素原空腹水平和胰岛素原/胰岛素比值与2小时血糖水平（作为连续变量）及肥胖均呈正相关，而与出生体重呈负相关。未发现与糖尿病家族史或年龄存在关联。这些发现表明，胰岛素原及胰岛素原/胰岛素比值升高是高血糖和胰岛素抵抗诱导的β细胞分泌需求增加的继发结果，而无糖尿病家族史的明显影响。
