Suzuki M, Kosegawa I, Miura S, Negishi K, Itabashi A, Katayama S, Ishii J, Kamata S, Fujita C
Fourth Department of Internal Medicine, Saitama Medical School, Japan.
Diabetes Res. 1991 Sep;18(1):11-7.
To evaluate the relationship of blood ketone bodies with diabetic control and endogenous insulin secretion, fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), fasting serum C-peptide (CPR), blood total ketone-bodies (TKB), blood acetoacetate (AcAc) and blood 3-hydroxybutyrate (3-OHB) were compared in 78 outpatients with non-insulin-dependent diabetes mellitus (NIDDM) treated with diet (n = 13), sulfonylurea (n = 52) and insulin (n = 13). TKB, AcAc and 3-OHB in patients treated with insulin were significantly higher than in patients treated with diet or sulfonylurea. In patients given diet therapy, log 3-OHB showed significant negative correlations with FPG, HbA1c and CPR. In patients treated with sulfonylurea, log 3-OHB showed significant positive correlations with FPG and HbA1c, but not with CPR. In patients treated with insulin, there were no correlations of log 3-OHB with FPG, HbA1c and CPR. For evaluation of the metabolic state in diabetes mellitus, measurement of blood ketone bodies is useful, and moreover necessary, in addition to diabetic control or determination of the endogenous insulin level.
为评估血酮体与糖尿病控制及内源性胰岛素分泌之间的关系，对78例接受饮食治疗（n = 13）、磺脲类药物治疗（n = 52）和胰岛素治疗（n = 13）的非胰岛素依赖型糖尿病（NIDDM）门诊患者的空腹血糖（FPG）、糖化血红蛋白（HbA1c）、空腹血清C肽（CPR）、血总酮体（TKB）、血乙酰乙酸（AcAc）和血3-羟基丁酸（3-OHB）进行了比较。接受胰岛素治疗的患者的TKB、AcAc和3-OHB显著高于接受饮食或磺脲类药物治疗的患者。在接受饮食治疗的患者中，log 3-OHB与FPG、HbA1c和CPR呈显著负相关。在接受磺脲类药物治疗的患者中，log 3-OHB与FPG和HbA1c呈显著正相关，但与CPR无关。在接受胰岛素治疗的患者中，log 3-OHB与FPG、HbA1c和CPR无相关性。对于评估糖尿病的代谢状态，除了糖尿病控制或内源性胰岛素水平的测定外，血酮体的测量是有用的，而且是必要的。
