·胰岛素抵抗及其相关疾病·

　　【摘要】 目的 探讨胰岛素(Ins)、胰升血糖素(Glu)和Ins/Glu比值与不同糖代谢状态的相关性。 方法 选取T2DM患者(T2DM组)81例、IGR患者(IGR组)35例及糖耐量正常(NGT组)者38名，均行75 g OGTT或标准馒头餐试验，分别测定各时点血糖、Ins和Glu水平。 结果 各组FIns水平比较，差异无统计学意义(P>0.05)。T2DM组0.5 hIns、1 hIns水平低于NGT和IGR组，IGR组2 hIns水平高于NGT组(P<0.01或P<0.05)。IGR组胰岛素曲线下面积(AUCi)较T2DM组升高(P<0.01)。除3 h外，T2DM组空腹及糖负荷后各时点Glu水平均高于NGT组和IGR组。T2DM组AUCglu较NGT组和IGR组增大(P<0.05)。T2DM组空腹、0.5 h及1 hIns/Glu比值均低于NGT组和IGR组(P<0.05)。AUCglu与体重、WC、BMI、HbA1c、Scr及SUA水平呈正相关(P<0.01)。 结论 Glu分泌紊乱是T2DM患者胰岛功能受损的重要表现。应用Ins/Glu比值能更好的反映胰岛α及β细胞功能异常情况。

　　【关键词】 糖代谢;胰升血糖素;胰岛素;相关性

　　Seruminsulin，glucagon levels and insulin/glucagon ratios in different glucose intolerance status WANG Xiao-qiang，WANG Xiao-lei，ZHANG Lei，et al.Department of Integrated Traditional and Western Medicine，Division of Liver Diseases，Qingdao Endocrine and Diabetes Hospital，Qingdao 266071，China

　　Corresponding author：ZHANG Lei，E-mail：diabetologist@126.com

　　【Abstract】 Objective To investigate the relationship between serum insulin，glucagon levels and insulin/glucagon ratios and different glucose intolerance status. Methods 81 patients with newly diagnosed type 2 diabetes (T2DM)，35 with impaired glucose regulation (IGR) and 38 with normal glucose tolerance (NGT) were enrolled. All subjects received 75 g oral glucose tolerance test with measurement of plasma glucose，insulin and glucagon at fasting and 0.5 h，1 h，2 h and 3 h. Results There was no difference on fasting insulin among NGT，IGR and T2DM group. Compared with NGT or IGR，T2DM had lower insulin levels at 0.5 h and 1 h after glucose load(P<0.01). IGR had higher insulin level at 2 h than NGT group(P<0.05). The area under the curve(AUC) of insulin was larger in IGR group than in DM group(P<0.01). T2DM patients had higher level of glucagon at fasting，0.5 h，1 h and 2 h compared with NGT or IGR.T2DM had the largest AUC of glucagon among three groups(P<0.05). The ratio of insulin to glucagon at fasting，0.5 h and 1 h were lower in T2DM group than in NGT and IGR group.The AUC of glucagon was positively associated with body weight，waist，BMI，HbA1c，serum creatinine and uric acid (P<0.05). Conclusion Glucagon secretion is impaired in T2DM patients accompanying with beta cell dysfunction. The ratio of insulin to glucagon may be a better parameter reflecting the pancreatic alpha and beta cell dysfunction.

　　【Key words】 Glycometabolism;Glucagon;Insulin;Correlation