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目的 了解真胰岛素 (TI)和前胰岛素 (PI)在肥胖症、糖耐量减低 (IGT)、2型糖尿病 (2 DM )患者中的改变 ,探讨其在评价胰岛B细胞分泌功能和胰岛素抵抗状态中的价值。方法 2 3例糖耐量正常者 (NGT)、35例IGT者、2 5例 2 DM患者行口服糖耐量试验 ,并根据体重指数 (BMI)分为肥胖和非肥胖组 ;采用ELISA方法 (其单克隆抗体能准确区分TI和PI)测定TI和PI ,采用放射免疫法测定IRI。结果 NGT、IGT、2 DM组内 :肥胖与非肥胖IRI、PI、TI曲线下面积差异均有显著性 (P <0 0 5)。IRI、TI曲线下面积 :IGT肥胖组 >NGT肥胖组 >2 DM肥胖组 >IGT非肥胖组 >NGT非肥胖组 >2 DM非肥胖组 ,差异有显著性 (P <0 0 5) ;PI曲线下面积、曲线下面积PI/ (PI +TI) :2 DM组 >NGT非肥胖组 ,差异有显著性 (P <0 0 5) ;IGT组、NGT非肥胖组相比未见差异有显著性 ;IS和ISI:NGT >IGT >2 DM ,差异有显著性 (P <0 0 5) ;相关分析空腹IRI与空腹TI:NGT、IGT、2 DM组肥胖者以及IGT非肥胖者呈正相关 (P <0 0 5)。IS与ISI呈正相关 (P <0 0 1 ) ;空腹PI与IS呈负相关 (P <0 0 5)。结论 IGT、NGT肥胖者具有高胰岛素血症 ;IRI常过高估计IGT、NGT、2 DM肥胖者的胰岛素水平 ;2 DM患者有不成比例的PI增高 ;PI在某种程度上可以估计胰岛B?
Objective To investigate the changes of true insulin (TI) and proinsulin (PI) in patients with obesity, impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM), and to investigate their role in the assessment of pancreatic B cell secretory function and insulin resistance the value of. Methods Twenty-three patients with normal glucose tolerance (NGT), 35 patients with IGT and 25 patients with 2 DM underwent oral glucose tolerance test and were divided into obesity and non-obese patients according to body mass index (BMI). ELISA was used Clonal antibodies can accurately distinguish between TI and PI) TI and PI, radioimmunoassay IRI. Results In the NGT, IGT and DM groups, there were significant differences in the area under the IRI, PI and TI curves between obese and non-obese subjects (P <0.05). IRI, TI area under the curve: IGT obesity group> NGT obesity group> 2 DM obesity group> IGT non-obese group> NGT non-obese group> 2 DM non-obese group, the difference was significant (P <0 05); PI curve Under the curve, PI / (PI + TI) under the curve area: 2 DM group> NGT non-obese group, the difference was significant (P <0 05); IGT group, NGT non-obese group, no significant difference (P <0.05). The correlation between fasting IRI and fasting TI: NGT, IGT, DM group 2 obese and IGT non-obese patients was positively correlated (P <0 05); IS and ISI: NGT> IGT> <0 0 5). There was a positive correlation between IS and ISI (P <0.01), but a negative correlation between fasting PI and IS (P <0.05). CONCLUSIONS IGT and NGT obesity have hyperinsulinemia; IRI often overestimates insulin levels in IGT, NGT, and 2DM obesity; 2 DM patients have a disproportionately high PI; and PI may, to some extent, estimate islet B