Chupin M, Charbonnel B, Chupin F
Acta Diabetol Lat. 1981 Apr-Jun;18(2):123-8. doi: 10.1007/BF02098997.
For further evaluation of B-cell secretion in diabetic keto-acidosis (KA) and in non-ketotic hyperosmolar coma (NKHC), basal and post-i.v. tolbutamide blood CPR and IRI values were measured in 34 patients (22 KA and 12 NKHC). FFA, cortisol and HGH measurements were also performed. IRI was low in both KA and NKHC (0.07 +/- 0.01 and 0.082 +/- 0.01 nmol/l) as opposed to CPR which was significantly higher in NKHC (1.14 +/- 0.1 nmol/l) than in KA (0.21 +/- 0.03 nmol/l). After tolbutamide injection, CPR and IRI levels did not change in any of the KA cases, whereas they significantly increased in half of the NKHC cases. Cortisol and FFA values were similarly increased in both situations, as opposed to HGH which was significantly higher (6.1 +/- 1.2 ng/ml) in KA than in NKHC (1.9 +/- 0.2 ng/ml). These results suggest that B-cell function is less deficient in NKHC than in KA. Residual insulin amounts reaching the liver via the portal vein could partly account for the absence of ketosis in NKHC.
为了进一步评估糖尿病酮症酸中毒（KA）和非酮症高渗性昏迷（NKHC）患者的B细胞分泌功能，我们对34例患者（22例KA患者和12例NKHC患者）测定了基础状态及静脉注射甲苯磺丁脲后的血C肽释放肽（CPR）和胰岛素释放指数（IRI）值。同时还进行了游离脂肪酸（FFA）、皮质醇和生长激素（HGH）的测定。与CPR相反，KA和NKHC患者的IRI均较低（分别为0.07±0.01和0.082±0.01 nmol/L），而NKHC患者的CPR（1.14±0.1 nmol/L）显著高于KA患者（0.21±0.03 nmol/L）。注射甲苯磺丁脲后，所有KA患者的CPR和IRI水平均未改变，而一半的NKHC患者的CPR和IRI水平显著升高。两种情况下皮质醇和FFA值均有类似升高，相反，KA患者的HGH水平（6.1±1.2 ng/ml）显著高于NKHC患者（1.9±0.2 ng/ml）。这些结果表明，NKHC患者的B细胞功能缺陷程度低于KA患者。经门静脉到达肝脏的残余胰岛素量可能是NKHC患者无酮症的部分原因。
