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目的采用多种参数观察分析胰岛β细胞功能,以探讨2型糖尿病患者病程与胰岛β细胞功能间的关系。方法 35例2型糖尿病患者,据病程分为3组:A组12例,病程<1年;B组15例,病程1～10年;C组8例,病程>10年。同步进行OGTT、C-肽、胰岛素释放试验及精氨酸试验,并测定胰岛素分泌指数(HOMA-β),胰岛素抵抗指数(HOMA-IR),一相胰岛素分泌指数(⊿TI)及胰岛素敏感指数(ISI)。结果 (1)OGTT、C-肽与胰岛素释放试验结果3组间的比较,随着病程的延长,各点血糖逐步升高,C-肽、胰岛素水平明显下降,组间差异均有显著性(P<0.01);(2)第一相胰岛素分泌指数(⊿TI)、胰岛素分泌指数(HOMA-β)两种β细胞功能指数在3组间的比较,随着病程的延长,β细胞功能逐渐减退,⊿TI、HOMAβ两指数变化趋势一致,组间有差异(P<0.01);(3)3组间胰岛素敏感指数(ISI)、HOMA-IR比较,无显著变化(P>0.05)。结论随着病程进展,β细胞功能逐渐减退,而胰岛素抵抗几乎贯穿于葡萄糖计量异常及糖尿病整个病程。
Objective To observe the function of pancreatic islet β cells by various parameters to explore the relationship between the duration of islet β cell function and the duration of type 2 diabetes mellitus. Methods 35 cases of type 2 diabetes mellitus were divided into 3 groups according to the course of disease: group A (12 cases), duration of disease (<1 year), group B (15 cases), duration of disease (1-10 years), group C (n = 8) and course of disease> 10 years. The OGTT, C-peptide, insulin release test and arginine test were performed synchronously. The levels of insulin secretion index (HOMA-β), insulin resistance index (HOMA-IR), first phase insulin secretion index (⊿TI) and insulin sensitivity index (ISI). Results (1) The results of OGTT, C-peptide and insulin release test results between the three groups, with the duration of the disease, each point of blood glucose increased gradually, C-peptide, insulin levels decreased significantly between the two groups were significant P <0.01). (2) Compared with the function index of the first phase insulin secretion index (⊿TI) and insulin secretion index (HOMA-β) in three groups, the function of β cells gradually increased with the prolongation of duration (P <0.01). (3) There was no significant change in ISI and HOMA-IR between the three groups (P> 0.05). Conclusion As the course of disease progresses, β-cell function gradually diminishes, and insulin resistance almost runs through glucose measurement abnormalities and diabetes throughout the course of the disease.