Yki-Järvinen H, Helve E, Laatikainen L, Karonen S L, Koivisto V A
Acta Endocrinol (Copenh). 1986 Apr;111(4):522-7. doi: 10.1530/acta.0.1110522.
Intact endothelial cell function has been suggested to be important for insulin action. An association between retinopathy and insulin resistance has been found in type 2 diabetes. To evaluate, whether insulin resistance is related to retinopathy in insulin dependent diabetes, we examined 36 type 1 diabetic patients with various degrees of retinopathy: 7 patients had proliferative, 15 had background and 14 patients had no retinopathy. The three groups were matched for age, sex, body weight and insulin dose. Compared with patients with no retinopathy, those with proliferative retinopathy had a longer (P less than 0.05) duration of diabetes (13 +/- 3 vs 22 +/- 3 years for no vs proliferative retinopathy), and higher (P less than 0.05) serum creatinine (74 +/- 4 vs 97 +/- 8 mumol/l), triglyceride (0.69 +/- 0.04 vs 1.02 +/- 0.17 mmol/l) and diastolic blood pressure (77 +/- 3 vs 90 +/- 10 mmHg) levels. The rate of insulin-mediated glucose metabolism (1 mU euglycaemic insulin clamp) was virtually identical in each diabetic group (4.80 +/- 0.42, 4.90 +/- 0.36 and 4.98 +/- 0.74 mg/kg/min) and 40% below that in 8 matched normal subjects (7.53 +/- 0.53 mg/kg/min, P less than 0.001). In conclusion, proliferative retinopathy is related to long duration of diabetes, incipient nephropathy and hypertension. Insulin resistance characterizes the majority of patients with type 1 diabetes but is unrelated to retinopathy.
完整的内皮细胞功能被认为对胰岛素作用很重要。在2型糖尿病中已发现视网膜病变与胰岛素抵抗之间存在关联。为了评估胰岛素抵抗是否与胰岛素依赖型糖尿病的视网膜病变相关，我们检查了36名患有不同程度视网膜病变的1型糖尿病患者：7名患者患有增殖性病变，15名患有背景性病变，14名患者没有视网膜病变。三组在年龄、性别、体重和胰岛素剂量方面相匹配。与无视网膜病变的患者相比，患有增殖性视网膜病变的患者糖尿病病程更长（P<0.05）（无增殖性视网膜病变组为13±3年，增殖性视网膜病变组为22±3年），血清肌酐水平更高（P<0.05）（74±4 vs 97±8 μmol/l）、甘油三酯水平更高（0.69±0.04 vs 1.02±0.17 mmol/l）以及舒张压更高（77±3 vs 90±10 mmHg）。每个糖尿病组中胰岛素介导的葡萄糖代谢率（1 mU正常血糖胰岛素钳夹）实际上是相同的（4.80±0.42、4.90±0.36和4.98±0.74 mg/kg/min），比8名匹配的正常受试者低40%（7.53±0.53 mg/kg/min，P<0.001）。总之，增殖性视网膜病变与糖尿病病程长、早期肾病和高血压有关。胰岛素抵抗是大多数1型糖尿病患者的特征，但与视网膜病变无关。
