Sapin Rémy
Unite d'Analyses Endocriniennes, Institut de Physique Biologique, CNRS/ULP UMR 7004, Faculté de Médecine, Strasbourg, France.
Clin Lab. 2003;49(3-4):113-21.
Insulin assays play a central role in the investigation of glucose metabolism disorders (investigation of the causes of hypoglycemia, assessment of beta-cell function and determination of pathogenesis of type 1 and type 2 diabetes), and in studies on the pharmacology of insulin itself. Greater convenience and improved reproducibility, sensitivity and specificity have been achieved with human insulin immunometric assays. Besides human insulin, insulin analogues (lispro, aspart and glargine) have been introduced to therapeutic use. The specificity of human insulin assays to these analogues should be assessed. Anti-insulin antibodies are present in a significant proportion of sera to be analyzed for insulin. The sensitivity of insulin assays to interference from these antibodies should also be assessed. Interferences from anti-insulin antibodies and hemolysis, which degrades insulin molecules, remain the main pitfalls of insulin assays. Immunometric assays have also improved the sensitivity and reproducibility of free insulin measurements. Standardization of insulin immunoassays is still called for.
胰岛素检测在葡萄糖代谢紊乱的研究（低血糖病因调查、β细胞功能评估以及1型和2型糖尿病发病机制的确定）以及胰岛素自身药理学研究中发挥着核心作用。人胰岛素免疫测定法带来了更大的便利性，提高了重现性、灵敏度和特异性。除了人胰岛素外，胰岛素类似物（赖脯胰岛素、门冬胰岛素和甘精胰岛素）已被用于治疗。应评估人胰岛素检测对这些类似物的特异性。在待分析胰岛素的血清中，相当一部分存在抗胰岛素抗体。还应评估胰岛素检测对这些抗体干扰的敏感性。抗胰岛素抗体和会降解胰岛素分子的溶血所造成的干扰，仍然是胰岛素检测的主要缺陷。免疫测定法也提高了游离胰岛素测量的灵敏度和重现性。胰岛素免疫测定的标准化仍有待实现。
