与未经血浆提取的检测相比，检测肠降血糖素的免疫分析法：日本 2 型糖尿病患者的肠降血糖素分泌。
Comparison of incretin immunoassays with or without plasma extraction: Incretin secretion in Japanese patients with type 2 diabetes.
机构信息
Division of Diabetes, Clinical Nutrition and Endocrinology, Kansai Electric Power Hospital, Osaka.
Department of Diabetes and Clinical Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
出版信息
J Diabetes Investig. 2012 Feb 20;3(1):70-9. doi: 10.1111/j.2040-1124.2011.00141.x.
UNLABELLED
Aims/Introduction: The effectiveness of incretin-based therapies in Asian type 2 diabetes requires investigation of the secretion and metabolism of glucose-dependent insulinotropic polypepide (GIP) and glucagon-like peptide 1 (GLP-1). Plasma extractions have been suggested to reduce variability in intact GLP-1 levels among individuals by removing interference that affects immunoassays, although no direct demonstration of this method has been reported. We have evaluated the effects of ethanol and solid-phase extractions on incretin immunoassays. We determined incretin levels during meal tolerance tests in Japanese patients with type 2 diabetes and characterized predictors for incretin secretion.
MATERIALS AND METHODS
Japanese patients with type 2 diabetes (23 anti-diabetic drug-naïve and 18 treated with sulfonylurea [SU] alone) were subjected to meal tolerance tests, and incretin levels were determined by immunoassays with or without extraction.
RESULTS
Intact GLP-1 levels determined by an intact GLP-1 immunoassay with ethanol and solid-phase extractions were lower than those determined without extraction. Intact GLP-1 levels determined by the extractions were highly correlated with each other, much more so than the levels with and without extraction. Total GLP-1 was unaffected by extractions, showing that extractions remove interference only in the case of intact GLP-1. Incretin secretion after meal ingestion was similar between drug-naïve and SU-treated patients. Fasting and postprandial GLP-1 levels were correlated positively with fasting free fatty acids and negatively with dipeptidyl peptidase-4 activity.
CONCLUSIONS
Ethanol and solid-phase extractions remove interference for intact GLP-1 immunoassay. SU showed little effect on incretin secretion. GLP-1 and GIP secretion were predicted by different factors. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00141.x, 2012).
目的/引言：在亚洲 2 型糖尿病中，肠降血糖素类治疗的有效性需要对葡萄糖依赖性胰岛素释放多肽（GIP）和胰高血糖素样肽 1（GLP-1）的分泌和代谢进行研究。有人提出，通过去除影响免疫测定的干扰物，血浆提取可以减少个体之间完整 GLP-1 水平的变异性，尽管尚未直接证明这种方法。我们评估了乙醇和固相提取对肠降血糖素免疫测定的影响。我们在日本 2 型糖尿病患者的耐餐试验中测定了肠降血糖素水平，并确定了肠降血糖素分泌的预测因素。
材料和方法
23 例未接受抗糖尿病药物治疗的日本 2 型糖尿病患者和 18 例仅接受磺酰脲类药物治疗的患者接受了耐餐试验，并通过免疫测定法（有或没有提取）测定了肠降血糖素水平。
结果
乙醇和固相提取后的完整 GLP-1 免疫测定法测定的完整 GLP-1 水平低于未提取的水平。经提取后测定的完整 GLP-1 水平彼此之间高度相关，与提取前后的水平相关性更高。提取对总 GLP-1 没有影响，表明提取仅去除完整 GLP-1 中的干扰物。餐后摄入后肠降血糖素的分泌在未接受药物治疗的患者和接受 SU 治疗的患者之间相似。空腹和餐后 GLP-1 水平与空腹游离脂肪酸呈正相关，与二肽基肽酶-4 活性呈负相关。
结论
乙醇和固相提取去除了完整 GLP-1 免疫测定的干扰。SU 对肠降血糖素的分泌影响较小。GLP-1 和 GIP 的分泌由不同的因素预测。（糖尿病研究与临床实践，doi：10.1111/j.2040-1124.2011.00141.x，2012）。
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