Owens D R, Vølund A, Jones D, Shannon A G, Jones I R, Birtwell A J, Luzio S, Williams S, Dolben J, Creagh F N
Department of Medicine, University of Wales College of Medicine, Heath Park, Cardiff, UK.
Diabetes Res. 1988 Oct;9(2):59-65.
One hundred and twenty-nine (97 M, 32 F) previously untreated non-insulin-dependent diabetic patients were studied. Meal and glucose (75 g) tolerance tests were performed on two separate days with glucose, C-peptide and insulin levels estimated during each with the inclusion of growth hormone during the meal test. In addition glycosylated haemoglobin (HbA1) and plasma creatinine levels were determined. Clinical evaluation included detailed ophthalmological examination following mydriasis. Differences between retinopaths (n = 21) and non-retinopaths (n = 108) were FPG 13.7 vs 11.6 (mmol/l) (p less than 0.01); HbA1: 12.9 vs 11.3 (%) (p less than 0.01); BMI: 25.2 vs 29.4 (kg/m2) (p less than 0.001); age 56.8 vs 52.4 (yr) (ns); creatinine: 91.2 vs 88.4 (mumol/l) (ns); systolic blood pressure: 152.4 vs 143.9 mmHg (ns); diastolic blood pressure 87.9 vs 87.7 mmHg (ns); fasting growth hormone: 4.6 +/- 0.9 vs 2.4 +/- 0.3 (mU/1) (p less than 0.01). Multivariate logistic analysis however revealed that systolic blood pressure in conjunction with the insulin response gave the most significant correlation with retinopathy. No significant correlation was observed with age, sex, diastolic blood pressure, creatinine, family history or smoking. The effect of disease duration could not be evaluated. B-cell function appears central to microvascular complications in non-insulin dependent diabetes mellitus.
对129例（男97例，女32例）未经治疗的非胰岛素依赖型糖尿病患者进行了研究。在两天内分别进行了进餐和葡萄糖（75克）耐量试验，期间测定葡萄糖、C肽和胰岛素水平，进餐试验时还测定了生长激素水平。此外，还测定了糖化血红蛋白（HbA1）和血浆肌酐水平。临床评估包括散瞳后的详细眼科检查。视网膜病变患者（n = 21）与无视网膜病变患者（n = 108）之间的差异为：空腹血糖13.7对11.6（mmol/L）（p<0.01）；HbA1：12.9对11.3（%）（p<0.01）；体重指数：25.2对29.4（kg/m²）（p<0.001）；年龄56.8对52.4（岁）（无统计学意义）；肌酐：91.2对88.4（μmol/L）（无统计学意义）；收缩压：152.4对143.9 mmHg（无统计学意义）；舒张压87.9对87.7 mmHg（无统计学意义）；空腹生长激素：4.6±0.9对2.4±0.3（mU/L）（p<0.01）。然而，多因素逻辑分析显示，收缩压与胰岛素反应相结合与视网膜病变的相关性最为显著。未观察到与年龄、性别、舒张压、肌酐、家族史或吸烟有显著相关性。疾病持续时间的影响无法评估。B细胞功能似乎是非胰岛素依赖型糖尿病微血管并发症的核心。
