J Intern Med. 2014 Jan;275(1):39-48. doi: 10.1111/joim.12116.
Simple methods for the evaluation of dynamic b-cell function in epidemiological and clinical studies of patients with type 2 diabetes (T2D) are needed. The aim of this study was to evaluate the dynamic beta-cell function in young patients with T2D with different disease durations and treatments.
Overall, 54 subjects with T2D from the Diabetes Incidence Study in Sweden (DISS) and 23 healthy control participants were included in this cross-sectional study. Beta-cell function was assessed by intravenous (i.v.) administration of arginine followed by i.v. glucose. The acute insulin and C-peptide responses to arginine (AIRarg and Ac-pepRarg, respectively) and to glucose (AIRglu and Ac-pepRglu, respectively)were estimated.Homeostasis model assessment of b-cell function(HOMA-b) andCpeptide assessments were also used for comparisons between patients with T2D and control participants.
AIRarg and Ac-pepRarg, but not AIRglu and Ac-pepRglu, could differentiate between patients with different disease durations. AIRglu values were 89% (P < 0.001) lower and AIRarg values were 29% (P < 0.01) lower in patients with T2D compared with control participants. HOMA-b and fasting plasma C-peptide levels did not differ between the T2D and control groups.
In young patients with T2D, the insulin secretory response to i.v. glucose is markedly attenuated, whereas i.v. arginine-stimulated insulin release is better preserved and can distinguish between patients with different disease duration and antidiabetic therapies. This suggests that the i.v. arginine stimulation test may provide an estimate of functional beta-cell reserve.
需要简单的方法来评估 2 型糖尿病（T2D）患者的流行病学和临床研究中的动态胰岛β细胞功能。本研究旨在评估不同病程和治疗的年轻 T2D 患者的动态胰岛β细胞功能。
本横断面研究共纳入来自瑞典糖尿病发病研究（DISS）的 54 例 T2D 患者和 23 例健康对照者。通过静脉内（i.v.）给予精氨酸后再给予 i.v. 葡萄糖来评估胰岛β细胞功能。分别评估精氨酸（AIRarg 和 Ac-pepRarg）和葡萄糖（AIRglu 和 Ac-pepRglu）刺激的急性胰岛素和 C 肽反应。还使用稳态模型评估胰岛β细胞功能（HOMA-b）和 C 肽评估来比较 T2D 患者和对照组参与者。
AIRarg 和 Ac-pepRarg 可以区分不同病程的患者，但 AIRglu 和 Ac-pepRglu 不能。与对照组相比，T2D 患者的 AIRglu 值低 89%（P < 0.001），AIRarg 值低 29%（P < 0.01）。HOMA-b 和空腹血浆 C 肽水平在 T2D 组和对照组之间没有差异。
在年轻的 T2D 患者中，静脉内葡萄糖刺激的胰岛素分泌明显减弱，而静脉内精氨酸刺激的胰岛素释放则更好地保留，并可以区分不同病程和抗糖尿病治疗的患者。这表明静脉内精氨酸刺激试验可以提供胰岛β细胞储备功能的估计。
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