II型糖尿病患者临床诊断后前3年期间β细胞功能与胰岛细胞抗体的关系。

Beta-cell function in relation to islet cell antibodies during the first 3 yr after clinical diagnosis of diabetes in type II diabetic patients.

作者信息

Gottsäter A, Landin-Olsson M, Fernlund P, Lernmark A, Sundkvist G

机构信息

Department of Medicine, University of Lund, Malmö General Hospital, Sweden.

出版信息

Diabetes Care. 1993 Jun;16(6):902-10. doi: 10.2337/diacare.16.6.902.

DOI:10.2337/diacare.16.6.902

PMID:8325204

Abstract

OBJECTIVE

To determine the effects of islet cell antibodies on beta-cell function during the first 3 yr after diagnosis in type II diabetic patients.

RESEARCH DESIGN AND METHODS

beta-cell function in type II diabetic patients with (n = 11, 50 +/- 5 yr of age) and without (n = 10, 52 +/- 4 yr of age) ICA was followed prospectively and compared with beta-cell function in type I adult diabetic patients (n = 17, 37 +/- 5 yr of age) and in healthy control subjects (n = 34, age 45 +/- 3 yr). beta-cell function was evaluated as fasting C-peptide, 1 + 3 min C-peptide after intravenous glucose, and delta C-peptide after glucagon.

RESULTS

Fasting C-peptide was equal in type II diabetic patients with ICA (0.30 +/- 0.03 nM) and type I diabetic patients (0.24 +/- 0.03 nM) at diagnosis, and decreased (P < 0.05) during 3 yr in these groups but not in type II diabetic patients without ICA. At diagnosis, type II diabetic patients with ICA showed a 1 + 3 min C-peptide (0.92 +/- 0.17 nM) lower (P < 0.001) than control subjects but higher (P < 0.05) than type I diabetic patients (0.53 +/- 0.11 nM). After 1 yr, 1 + 3 min C-peptide in type II diabetic patients with ICA had decreased (P < 0.05) to 0.18 +/- 0.11 nM and was equal to type I diabetic patients (0.38 +/- 0.10 nM). delta C-peptide after glucagon was equally impaired in type II diabetic patients with ICA (0.38 +/- 0.06 nM) and type I diabetic patients (0.35 +/- 0.11 nM) at diagnosis. After 3 yr, type II diabetic patients with ICA had fasting C-peptide of 0.09 +/- 0.04 nM, 1 + 3 min C-peptide of 0.18 +/- 0.10 nM, and delta C-peptide after glucagon of 0.20 +/- 0.09 nM, values equal to type I diabetic patients but lower (P < 0.01) than in type II diabetic patients without ICA, whose values remained unchanged; fasting C-peptide of 0.97 +/- 0.17 nM, 1 + 3 min C-peptide of 2.31 +/- 0.50 nM, and delta C-peptide after glucagon of 1.76 +/- 0.28 nM.

CONCLUSIONS

In patients considered type II diabetic with ICA, beta-cell function progressively decreased after diagnosis, and after 3 yr was similar to type I diabetic patients, whereas beta-cell function in type II diabetic patients without ICA was unchanged.

摘要

目的

确定胰岛细胞抗体对II型糖尿病患者诊断后最初3年β细胞功能的影响。

研究设计与方法

对有胰岛细胞抗体（n = 11，年龄50±5岁）和无胰岛细胞抗体（n = 10，年龄52±4岁）的II型糖尿病患者的β细胞功能进行前瞻性随访，并与I型成年糖尿病患者（n = 17，年龄37±5岁）和健康对照者（n = 34，年龄45±3岁）的β细胞功能进行比较。β细胞功能通过空腹C肽、静脉注射葡萄糖后1 + 3分钟C肽以及胰高血糖素后△C肽进行评估。

结果

诊断时，有胰岛细胞抗体的II型糖尿病患者（0.30±0.03 nM）和I型糖尿病患者（0.24±0.03 nM）的空腹C肽相等，在3年期间这些组的空腹C肽下降（P < 0.05），但无胰岛细胞抗体的II型糖尿病患者空腹C肽未下降。诊断时，有胰岛细胞抗体的II型糖尿病患者的1 + 3分钟C肽（0.92±0.17 nM）低于对照组（P < 0.001）但高于I型糖尿病患者（0.53±0.11 nM）（P < 0.05）。1年后，有胰岛细胞抗体的II型糖尿病患者的1 + 3分钟C肽下降（P < 0.05）至0.18±0.11 nM，与I型糖尿病患者（0.38±0.10 nM）相等。诊断时，有胰岛细胞抗体的II型糖尿病患者（0.38±0.06 nM）和I型糖尿病患者（0.35±0.11 nM）的胰高血糖素后△C肽同样受损。3年后，有胰岛细胞抗体的II型糖尿病患者的空腹C肽为0.09±0.04 nM，1 + 3分钟C肽为0.18±0.10 nM，胰高血糖素后△C肽为0.20±0.09 nM，这些值与I型糖尿病患者相等，但低于无胰岛细胞抗体的II型糖尿病患者（P < 0.01），后者的值保持不变；空腹C肽为0.97±0.17 nM，1 + 3分钟C肽为2.31±0.50 nM，胰高血糖素后△C肽为1.76±0.28 nM。