Matsuda A, Kuzuya T
Diabetes Care. 1982 Nov-Dec;5(6):581-4. doi: 10.2337/diacare.5.6.581.
C-peptide immunoreactivity (CPR) in 24-h urine was assayed in 13 diabetic patients during and after recovery from ketoacidosis. In 10 patients who remained insulin-dependent on discharge and in the subsequent follow-up period, urine CPR was low (18 micrograms/day or less), while in three patients who were ultimately controlled by diet or sulfonylureas, urine CPR was normal (59-92 micrograms/day, normal value 74 +/- 26 micrograms/day). In the latter group, urine CPR in one patient assayed during ketoacidosis was 6 micrograms/day and, in another patient, it was 22 micrograms/day on the 3rd day of the admission. This may imply that in the latter group, B-cell function was decompensated in ketoacidosis, but was restored after recovery. Clinical courses suggested that these patients were not in the remission phase of IDDM, but belonged to NIDDM. Among other groups of diabetic patients, urine CPR in those treated with diet or sulfonylureas was 72 +/- 30 micrograms/day and always higher than 20 micrograms/day. The prevalence of urine CPR less than 20 micrograms/day was more frequent in those with younger onset of diabetes, higher insulin dosage, unstable diabetes, or previous history of ketoacidosis among insulin-treated patients. We suggest that urine CPR less than 20 micrograms/day is an index of insulin dependency, although in a state of extreme decompensation of B-cells such as in ketoacidosis, urine CPR can be decreased low even in NIDDM.
对13例糖尿病患者在酮症酸中毒期间及恢复后测定了24小时尿中的C肽免疫反应性（CPR）。10例出院时仍依赖胰岛素且在随后随访期内的患者，尿CPR较低（每天18微克或更低），而3例最终通过饮食或磺脲类药物控制的患者，尿CPR正常（每天59 - 92微克，正常值为74±26微克/天）。在后一组中，1例在酮症酸中毒期间测定的患者尿CPR为每天6微克，另一例患者在入院第3天为每天22微克。这可能意味着后一组患者在酮症酸中毒时B细胞功能失代偿，但恢复后得以恢复。临床病程表明这些患者并非IDDM缓解期，而是属于NIDDM。在其他糖尿病患者组中，接受饮食或磺脲类药物治疗的患者尿CPR为72±30微克/天，且始终高于20微克/天。在糖尿病发病年龄较轻、胰岛素剂量较高、糖尿病不稳定或胰岛素治疗患者中有酮症酸中毒既往史的患者中，尿CPR低于20微克/天的发生率更高。我们认为尿CPR低于20微克/天是胰岛素依赖的一个指标，尽管在B细胞极度失代偿状态如酮症酸中毒时，即使是NIDDM患者尿CPR也可能降低。
