论文部分内容阅读
目的研究口服葡萄糖-胰岛素释放试验(OGIRT)的胰岛素(Ins)分泌曲线特点,初步探讨适用于临床评价个体胰岛素敏感性和β细胞分泌功能的方法。方法对12例正常糖耐量者行OGIRT和静脉糖耐量试验(IVGTT),观察OGIRT、IVGTT血浆Ins分泌峰值时间分布频数,分析胰岛素敏感性和β细胞功能各指标相关指数。结果 OGIRT血浆Ins分泌高峰出现于35～45min,无明显第二分泌峰。经多因素线性回归分析表明20、30、35min Ins增值与葡萄糖增值的比值(ΔI_(20)/ΔG_(20)、ΔI_(30)/ΔG_(30)、ΔI_(35)/ΔG_(35))与第一相(1PH)胰岛素分泌、葡萄糖及胰岛素曲线下面积比值(SGI)、胰岛素作用指数(IAI)、HOMA-IR、胰岛素分泌指数均不相关(P>0.05),ΔI_(40)/ΔG_(40)与SGI、IAI、HOMA-IR显著相关(P均<0.01)。结论 OGIRT可能不能反映1PH;OGIRTΔI_(40)/ΔG_(40)比I_(20)/ΔG_(20)、ΔI_(30)/ΔG_(30)能更好地评估β细胞功能。
OBJECTIVE: To study the characteristics of insulin secretion curve of oral glucose-insulin release test (OGIRT), and to investigate the clinical application of OGIRT in insulin sensitivity and β-cell secretion. Methods OGIRT and IVGTT were performed in 12 patients with normal glucose tolerance. The peak time distribution of Ins secretion in OGIRT and IVGTT was observed. The indexes related to insulin sensitivity and β-cell function were analyzed. Results The peak of Ins secretion in plasma of OGIRT appeared in 35 ~ 45min with no obvious second secretion peak. The multivariate linear regression analysis showed that the ratio of Ins value to glucose increment (ΔI_ (20) / ΔG_ (20), ΔI_ (30) / ΔG_ (30), ΔI_ (35) / ΔG_ (P> 0.05), ΔI_ (40) / ΔG_ (1) and insulin secretion, glucose and insulin area ratio (SGI), insulin action index (IAI), HOMA-IR and insulin secretion index of the first phase (1PH) (40) was significantly associated with SGI, IAI and HOMA-IR (all P <0.01). CONCLUSION OGIRT may not reflect 1PH; OGIRTΔI_ (40) / ΔG_ (40) is better than I_ (20) / ΔG_ (20), ΔI_ (30) / ΔG_ (30)