Clark P M, Levy J C, Cox L, Burnett M, Turner R C, Hales C N
Department of Clinical Biochemistry, Addenbrooke's Hospital, Cambridge, UK.
Diabetologia. 1992 May;35(5):469-74. doi: 10.1007/BF02342446.
Plasma insulin, intact proinsulin and 32-33 split proinsulin measured by specific immunoradiometric assays and insulin and C-peptide measured by radioimmunoassay were measured during a constant infusion of glucose test in ten diet-treated subjects with a history of Type 2 (non-insulin-dependent) diabetes (termed diabetic subjects), mean fasting plasma glucose 6.0 +/- 1.0 mmol/l (mean +/- SD), and 12 non-diabetic control subjects. Immunoreactive insulin concentrations measured by radioimmunoassay were 33% higher than insulin and 16% higher than the sum of insulin and its precursors by immunoradiometric assay. The diabetic and non-diabetic subjects had similar fasting concentrations of insulin, intact proinsulin and 32-33 split proinsulin. The ratio of fasting intact proinsulin to total insulin was greater in the diabetic than the non-diabetic group 12.0% (6.8-21.0%, 1 SD range) and 6.3% (4.0-9.8%), respectively, p less than 0.01), though the groups overlapped substantially. After glucose infusion, diabetic and non-diabetic subjects had similar intact proinsulin concentrations (geometric mean 4.9 and 5.2 pmol/l, respectively), but the diabetic group had impaired insulin secretion by immunoradiometric assay (geometric means 55 and 101 pmol/l, p less than 0.05) or by radioimmunoassay C-peptide (geometric means 935 and 1410 pmol/l, p less than 0.05), though not by radioimmunoassay insulin (87 and 144 pmol/l, p = 0.12), respectively. Individual immunoradiometric assay insulin responses to glucose expressed in terms of obesity were subnormal in nine of ten diabetic subjects. Radioimmunoassay insulin and C-peptide gave less complete discrimination (subnormal responses in six of ten and eight of ten, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
通过特异性免疫放射分析测定血浆胰岛素、完整胰岛素原和32-33裂解胰岛素原，通过放射免疫分析测定胰岛素和C肽，在10名有2型（非胰岛素依赖型）糖尿病病史（称为糖尿病患者）且平均空腹血糖为6.0±1.0 mmol/L（平均值±标准差）的饮食治疗患者以及12名非糖尿病对照者的葡萄糖持续输注试验期间进行测量。通过放射免疫分析测定的免疫反应性胰岛素浓度比胰岛素高33%，比通过免疫放射分析测定的胰岛素及其前体总和高16%。糖尿病患者和非糖尿病患者的空腹胰岛素、完整胰岛素原和32-33裂解胰岛素原浓度相似。糖尿病组空腹完整胰岛素原与总胰岛素的比值高于非糖尿病组，分别为12.0%（6.8-21.0%，1个标准差范围）和6.3%（4.0-9.8%），p<0.01），尽管两组有很大重叠。葡萄糖输注后，糖尿病患者和非糖尿病患者的完整胰岛素原浓度相似（几何平均值分别为4.9和5.2 pmol/L），但糖尿病组通过免疫放射分析（几何平均值分别为55和101 pmol/L，p<0.05）或放射免疫分析C肽（几何平均值分别为935和1410 pmol/L，p<0.05）显示胰岛素分泌受损，尽管通过放射免疫分析胰岛素（87和144 pmol/L，p = 0.12）未显示受损。以肥胖程度表示的10名糖尿病患者中有9名个体免疫放射分析胰岛素对葡萄糖的反应低于正常水平。放射免疫分析胰岛素和C肽的区分度较低（分别为10名中有6名和10名中有8名反应低于正常水平）。（摘要截断于250字）
