Iwase M, Kikuchi M, Nunoi K, Maki Y, Wakisaka M, Wada M, Fujishima M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Endocrinol Jpn. 1988 Dec;35(6):803-8. doi: 10.1507/endocrj1954.35.803.
We have evaluated the residual pancreatic B cell function by glucagon load test in 28 patients with non-insulin-dependent diabetes mellitus (NIDDM) of a duration of 20 years or more. The increase in serum C-peptide at 6 minutes after glucagon administration (delta C-peptide) was used as an index of residual B cell function. There was much less delta C-peptide in patients treated with insulin than in those treated with sulfonylurea (p less than 0.05), and it was significantly correlated with the body mass index (r = 0.40, p less than 0.05). Long term metabolic control assessed by the average annual mean fasting blood glucose for the observation period (mean, 21 years) was not correlated with delta C-peptide (r = -0.13). The prevalence of retinopathy which needed photocoagulation therapy and of neuropathy in patients with poor residual B cell function (delta C-peptide less than or equal to 0.3 ng/ml) was the same as that in those with good residual B cell function (delta C-peptide greater than or equal to 1.0 ng/ml). The present study shows that the residual B cell function is not correlated with long term glycemic control and the prevalence of diabetic complications in long-standing NIDDM patients.
我们通过胰高血糖素负荷试验评估了28例病程达20年及以上的非胰岛素依赖型糖尿病（NIDDM）患者残余的胰腺B细胞功能。胰高血糖素给药后6分钟时血清C肽的增加值（△C肽）被用作残余B细胞功能的指标。接受胰岛素治疗的患者的△C肽比接受磺脲类药物治疗的患者少得多（p<0.05），且其与体重指数显著相关（r = 0.40，p<0.05）。通过观察期（平均21年）的年均空腹血糖评估的长期代谢控制与△C肽不相关（r = -0.13）。残余B细胞功能差（△C肽≤0.3 ng/ml）的患者中需要进行光凝治疗的视网膜病变和神经病变的患病率与残余B细胞功能良好（△C肽≥1.0 ng/ml）的患者相同。本研究表明，在病程较长的NIDDM患者中，残余B细胞功能与长期血糖控制及糖尿病并发症的患病率不相关。
