Hartling S G, Garne S, Binder C, Heilmann C, Petersen W, Petersen K E, Koch C
Steno Memorial Hospital, Gentofte, Denmark.
Diabetes Res. 1988 Apr;7(4):165-9.
The beta-cell response to an oral glucose load was studied in 22 patients with cystic fibrosis (CF) by means of insulin, C-peptide and proinsulin, and the results compared with those from 20 healthy sex and age matched controls. According to WHO criteria two had diabetes mellitus, eight had impaired glucose tolerance and twelve had normal glucose tolerance. All patients showed lower insulin and C-peptide levels than the controls at 30 minutes. However the insulin and C-peptide responses were sustained so that the areas under the curves were comparable between controls, CF patients with normal glucose tolerance, and CF patients with impaired glucose tolerance. By contrast, the area under the proinsulin curve was significantly higher in the CF patients with impaired glucose tolerance compared with both controls (p less than 0.05) and with the CF normal glucose tolerance group (p less than 0.02). In the CF patients with impaired glucose tolerance the proinsulin level was significantly elevated at 120 minutes (median 50 pmol/l) and at 180 minutes (29 pmol/l) as compared with the controls (24 and 19 pmol/l p less than 0.01) and with the CF patients with normal glucose tolerance (21 and 16 pmol/l p less than 0.01). These data confirm that impaired glucose tolerance and diabetes is frequent in cystic fibrosis. The elevated proinsulin immunoreactive material in CF patients with impaired glucose tolerance may partly compensate for the relative insufficient insulin response found in these patients.
通过检测胰岛素、C肽和胰岛素原，对22例囊性纤维化（CF）患者口服葡萄糖负荷后的β细胞反应进行了研究，并将结果与20名年龄和性别匹配的健康对照者进行了比较。根据世界卫生组织标准，2例患有糖尿病，8例糖耐量受损，12例糖耐量正常。所有患者在30分钟时的胰岛素和C肽水平均低于对照组。然而，胰岛素和C肽反应持续存在，因此对照组、糖耐量正常的CF患者和糖耐量受损的CF患者之间的曲线下面积具有可比性。相比之下，糖耐量受损的CF患者胰岛素原曲线下面积显著高于对照组（p<0.05）和糖耐量正常的CF组（p<0.02）。与对照组（分别为24和19 pmol/l，p<0.01）以及糖耐量正常的CF患者（分别为21和16 pmol/l，p<0.01）相比，糖耐量受损的CF患者在120分钟（中位数50 pmol/l）和180分钟（29 pmol/l）时胰岛素原水平显著升高。这些数据证实，糖耐量受损和糖尿病在囊性纤维化中很常见。糖耐量受损的CF患者中胰岛素原免疫反应性物质升高可能部分补偿了这些患者中发现的相对不足的胰岛素反应。
