Coppack S W, Thursfield V, Dhar H, Hockaday T D
Sheikh Rashid Diabetes Unit, Radcliffe Infirmary, Oxford, UK.
Diabet Med. 1991 Aug-Sep;8(7):629-37. doi: 10.1111/j.1464-5491.1991.tb01669.x.
The most appropriate way to estimate islet B-cell function in Type 2 diabetes is unclear, and this has led to many different techniques of measurement being used. We have examined the associations to two fasting and four glucose-stimulated indices of islet B-cell function in members of a group of 249 Type 2 patients, seeking correlations with concurrent glucose tolerance and antilipolytic effect, and with subsequent clinical outcome. The six B-cell indices were interrelated to variable degrees (rs -0.21 to +0.92). Early glucose-stimulated insulin output (incremental 1st-phase insulin area) was not significantly positively correlated with the fasting plasma concentration of immunoreactive insulin at any time. Fasting immunoreactive insulin and 'minimal model' islet B-cell parameters were poorly related to the rate constant for glucose clearance and the degree of antilipolysis (rs values between -0.13 and +0.40). Homeostatic model assessment of the fasting islet B-cell function was more consistently related to these metabolic effects. Incremental first-phase insulin area was the islet B-cell index most consistently related to metabolic abnormalities (rs up to +0.56), and to subsequent need for oral hypoglycaemic or exogenous insulin therapy. No index of islet B-cell function was consistently associated with the subsequent development of diabetic tissue damage.
目前尚不清楚评估2型糖尿病患者胰岛B细胞功能的最合适方法，这导致了许多不同的测量技术被采用。我们在一组249例2型患者中，研究了胰岛B细胞功能的两个空腹指标和四个葡萄糖刺激指标之间的关联，寻找其与同时存在的糖耐量和抗脂解作用以及随后临床结局的相关性。这六个B细胞指标在不同程度上相互关联（相关系数rs为-0.21至+0.92）。早期葡萄糖刺激的胰岛素分泌（增量第一相胰岛素面积）在任何时候与空腹血浆免疫反应性胰岛素浓度均无显著正相关。空腹免疫反应性胰岛素和“最小模型”胰岛B细胞参数与葡萄糖清除率常数和抗脂解程度的相关性较差（相关系数rs值在-0.13至+0.40之间）。空腹胰岛B细胞功能的稳态模型评估与这些代谢效应的相关性更为一致。增量第一相胰岛素面积是与代谢异常最一致相关的胰岛B细胞指标（相关系数rs高达+0.56），并且与随后口服降糖药或外源性胰岛素治疗的需求相关。没有胰岛B细胞功能指标与随后糖尿病组织损伤的发生始终相关。
