Rastogi G K, Sialy R, Sinha M K, Dash R, Chopra J S, Kataria R N
Acta Diabetol Lat. 1975 Sep-Dec;12(5-6):309-23. doi: 10.1007/BF02581104.
The serum levels of total immunoreactive insulin (IRI) and proinsulin-like component (PLC) in the fasting state and following the administration of insulin secretagogues in 5 patients with organic hyperinsulinism and age and sex matched normal subjects are reported. Diagnosis of organic hyperinsulinism could be established in all instances on the basis of the inappropriately high total serum IRI levels for the corresponding blood glucose values; such an abnormal relationship was not seen in normal subjects, and was further enhanced by insulin secretagogues. Unrestrained insulin secretion in organic hyperinsulinism was enhanced following the administration of glucose, tolbutamide, glucagon or amino acids; the last 2 stimuli are known to be ineffective in causing insulin secretion in the presence of hypoglycemia in normal subjects. Four patints had insulinomas and one probably had islet cell hyperplasia or abnormal function of islet cells. Chromatography of serum IRI to quantitate PLC is a useful adjunct to the diagnosis of organic hyperinsulinism as in the fasting state the proportion of PLC is always elevated, above the normal range of 5-22%. Following the administration of insulin secretagogues there was pronounced increase in total serum IRI in organic hyperinsulinism but the proportion of PLC generally decreased, suggesting thereby that mojor increase in IRI was due to release of stored granular IRI which is known to have a low proportion of PLC.
报告了5例器质性高胰岛素血症患者及年龄、性别匹配的正常受试者在空腹状态下以及给予胰岛素促分泌剂后的血清总免疫反应性胰岛素（IRI）和胰岛素原样成分（PLC）水平。在所有病例中，根据相应血糖值下血清总IRI水平异常升高可确诊器质性高胰岛素血症；正常受试者未见这种异常关系，且胰岛素促分泌剂可进一步增强这种异常关系。给予葡萄糖、甲苯磺丁脲、胰高血糖素或氨基酸后，器质性高胰岛素血症中不受抑制的胰岛素分泌增强；已知后两种刺激在正常受试者低血糖时不会引起胰岛素分泌。4例患者患有胰岛素瘤，1例可能患有胰岛细胞增生或胰岛细胞功能异常。血清IRI色谱法用于定量PLC是诊断器质性高胰岛素血症的有用辅助手段，因为在空腹状态下PLC的比例总是升高，高于5%-22%的正常范围。给予胰岛素促分泌剂后，器质性高胰岛素血症患者血清总IRI显著增加，但PLC的比例通常降低，这表明IRI的主要增加是由于储存的颗粒状IRI释放，已知其PLC比例较低。
