Simell T, Mäenpää J, Kaprio E A, Hakulinen A, Hakalax J, Sipilä I, Akerblom H K, Simell O
I Department of Paediatrics, Children's Hospital, University of Helsinki, Finland.
Diabetologia. 1995 Jan;38(1):97-105. doi: 10.1007/BF02369358.
We studied associations of 24-h serum insulin profiles with insulin dose, age, gender, haemoglobin A1c (HbA1c) and C-peptide values, as well as blood glucose profiles in 77 consecutive children-nine aged 2-4, 14 aged 5-8, 26 aged 9-12, and 28 aged 13-17 years--2 years after the onset of insulin-dependent diabetes mellitus (IDDM). Mean weight-based insulin doses in the four age groups were similar (0.7 +/- 0.2 U.kg-1.day-1 in all); body surface-area-based doses differed. Insulin doses correlated significantly with the 24-h mean and area-under-the-curve (AUC) values, and with mean values at 03.00 hours of serum insulin in the children aged 5-8 and 13-17 years. The mean insulin concentrations of the age groups (95% confidence intervals) increased with age [6.1 (3.8, 9.7), 7.6 (5.9, 9.8), 10.4 (8.6, 12.4), and 14.0 (11.6, 16.8) mU/l; p < 0.0002]. The 24-h mean of serum insulin together with HbA1c concentration predicted 32% of the variation of mean blood glucose concentrations. Of children aged less than 9 years, 50% had insulin values less than 5 mU/l (healthy subjects' lower reference limit), and 14% were of less than 2 mU/l (detection limit of the assay) at 03.00 hours. At 07.00 hours, 82% had insulin values of less than 5 mU/l, and 36% were of less than 2 mU/l, respectively. Some young children had night-time hypoglycaemia with simultaneous hypoinsulinaemia. Insulin profiles correlated poorly with the HbA1c and peak C-peptide values.(ABSTRACT TRUNCATED AT 250 WORDS)
我们研究了77例胰岛素依赖型糖尿病（IDDM）发病2年后的连续儿童（9例2 - 4岁、14例5 - 8岁、26例9 - 12岁、28例13 - 17岁）的24小时血清胰岛素谱与胰岛素剂量、年龄、性别、糖化血红蛋白（HbA1c）和C肽值以及血糖谱之间的关联。四个年龄组基于体重的平均胰岛素剂量相似（均为0.7±0.2 U·kg⁻¹·天⁻¹）；基于体表面积的剂量有所不同。胰岛素剂量与24小时均值和曲线下面积（AUC）值以及5 - 8岁和13 - 17岁儿童03:00时的血清胰岛素均值显著相关。各年龄组的平均胰岛素浓度（95%置信区间）随年龄增加而升高[6.1（3.8，9.7）、7.6（5.9，9.8）、10.4（8.6，12.4）和14.0（11.6，16.8）mU/l；p < 0.0002]。24小时血清胰岛素均值与HbA1c浓度共同预测了平均血糖浓度变化的32%。9岁以下儿童中，50%在03:00时胰岛素值低于5 mU/l（健康受试者的下限参考值），14%低于2 mU/l（检测限）。在07:00时，分别有82%和36%的儿童胰岛素值低于5 mU/l和2 mU/l。一些幼儿出现夜间低血糖并伴有低胰岛素血症。胰岛素谱与HbA1c和C肽峰值的相关性较差。（摘要截断于250字）
