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2型糖尿病中的残余β细胞功能及肝脏胰岛素摄取评估

Residual beta-cell function in type II diabetes and evaluation of the hepatic insulin extraction.

作者信息

Toledo e Souza I T, Wajchenberg B L, Prestes Cesar F, Almeida Neto J S

出版信息

Horm Metab Res. 1983 Dec;15(12):575-80. doi: 10.1055/s-2007-1018797.

Abstract

Insulin and C-peptide (free insulin and C-peptide in insulin-treated patients) were measured after glucose stimulation in nine Type II diabetics on chlorpropamide, eleven insulin-treated maturity-onset diabetics and in 8 normal controls. Dissociation between C-peptide and insulin response to glucose was observed in several diabetics. The relation between incremental molar areas under C-peptide and insulin curves, after glucose challenge (delta CPR - delta IRI/delta CPR) were used to evaluate the hepatic insulin extraction in all but the insulin-treated diabetics. The lower insulin requirements and better control of the short-duration insulin-treated maturity-onset diabetics in relation to the long-term ones could not be explained either by the residual insulin secretion or by the level of "insulin antibodies". The chlorpropamide-responsive patients presented higher insulin levels after the glucose challenge and a lower hepatic insulin extraction than the non-responsive ones.

摘要

在葡萄糖刺激后,对9名服用氯磺丙脲的II型糖尿病患者、11名接受胰岛素治疗的成年发病型糖尿病患者以及8名正常对照者测定了胰岛素和C肽(胰岛素治疗患者中的游离胰岛素和C肽)。在数名糖尿病患者中观察到C肽与胰岛素对葡萄糖的反应之间存在分离。除胰岛素治疗的糖尿病患者外,在所有受试者中,利用葡萄糖激发后C肽曲线下与胰岛素曲线下的增量摩尔面积之比(δCPR-δIRI/δCPR)来评估肝脏对胰岛素的提取。短期胰岛素治疗的成年发病型糖尿病患者与长期胰岛素治疗的患者相比,胰岛素需求量较低且控制较好,这既不能用残余胰岛素分泌来解释,也不能用“胰岛素抗体”水平来解释。与无反应者相比,氯磺丙脲反应性患者在葡萄糖激发后呈现出更高的胰岛素水平和更低的肝脏胰岛素提取率。

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