Carel J C, Boitard C, Bougnères P F
René Descartes University, Institut National de la Sante et de la Recherche Medicale U342 and Pediatric Endocrinology, St. Vincent de Paul Hospital, Paris, France.
J Clin Invest. 1993 Jul;92(1):509-13. doi: 10.1172/JCI116595.
Measurement of beta-cell function is an important marker of progression to diabetes in individuals at risk for the disease. Although the peak incidence for the disease occurs before 17 years of age, normal values for insulin secretion were not available in this age group. We performed a simplified intravenous glucose tolerance test in 167 normal children, and in 98 islet cell antibody (ICA)-negative and 12 ICA-positive siblings of diabetic patients. Their age range was 1-16 yr. The first phase of insulin secretion, evaluated as the sum of plasma insulin concentrations at 1 and 3 min, increased with age and was significantly lower in ICA-negative siblings (86 +/- 6 microU/ml, P < 0.002) than in normal controls (115 +/- 6 microU/ml). This difference was not apparent before 8 yr of age. None of the ICA-negative siblings developed diabetes after an average of 4.5 yr. ICA-positive siblings at first study had a first phase insulin response similar to that of ICA negative siblings, but significantly lower than that of the normal controls (74 +/- 13 microU/ml, P < 0.02). The reason for the decreased insulin secretion in ICA-negative siblings is unknown, but could involve a defect in the growth of beta-cell mass or insulin secretion that could be part of the multifactorial pathogenesis of type 1 diabetes.
测量β细胞功能是处于糖尿病发病风险个体病情进展的一项重要指标。尽管该疾病的发病高峰出现在17岁之前，但这个年龄组尚无胰岛素分泌的正常参考值。我们对167名正常儿童、98名胰岛细胞抗体（ICA）阴性以及12名糖尿病患者的ICA阳性同胞进行了简化的静脉葡萄糖耐量试验。他们的年龄范围是1至16岁。胰岛素分泌的第一阶段，以1分钟和3分钟时血浆胰岛素浓度之和来评估，随年龄增长而增加，且ICA阴性同胞（86±6微单位/毫升，P<0.002）显著低于正常对照组（115±6微单位/毫升）。这种差异在8岁之前并不明显。平均4.5年后，ICA阴性同胞中无人患糖尿病。首次研究时，ICA阳性同胞的第一阶段胰岛素反应与ICA阴性同胞相似，但显著低于正常对照组（74±13微单位/毫升，P<0.02）。ICA阴性同胞胰岛素分泌减少的原因尚不清楚，但可能涉及β细胞量增长或胰岛素分泌方面的缺陷，这可能是1型糖尿病多因素发病机制的一部分。
