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目的 探讨 2型糖尿病患者血清免疫反应性胰岛素、真胰岛素、瘦素间相互调节作用。方法 分别用放免法和酶联免疫吸附测定法测定了 39例 2型糖尿病患者和 31例正常人免疫反应性胰岛素、真胰岛素和瘦素水平 ,计算三者间及其与胰岛素和真胰岛素敏感性指标的相关关系。结果 2型糖尿病患者免疫反应性胰岛素较正常人明显增高 (P <0 0 5 ) ,真胰岛素、瘦素无明显变化 ,免疫反应性胰岛素 /真胰岛素明显增高 ,胰岛素敏感性下降。正常人免疫反应性胰岛素、真胰岛素、瘦素之间有很好的正相关关系 ,2型糖尿病患者三者间则完全无关 ,但它们均与免疫反应性胰岛素 /真胰岛素有很好的相关关系 (P <0 0 1)。正常人及肥胖糖尿病患者的免疫反应性胰岛素、瘦素均升高 ,真胰岛素正常。结论 2型糖尿病患者存在着胰岛素抵抗、真胰岛素相对不足和胰岛素 瘦素轴的平衡失调。测定真胰岛素和免疫反应性胰岛素 /真胰岛素比只测定免疫反应性胰岛素更能确切地反映 β细胞功能 ,临床意义更大。肥胖是胰岛素抵抗及瘦素抵抗的重要原因
Objective To investigate the mutual regulation of serum immunoreactive insulin, true insulin and leptin in type 2 diabetic patients. Methods The levels of immunoreactive insulin, true insulin and leptin in 39 patients with type 2 diabetes mellitus and 31 normal individuals were measured by radioimmunoassay and enzyme-linked immunosorbent assay, respectively, and their sensitivity to insulin and true insulin The relationship between the indicators. Results Immunoreactive insulin in patients with type 2 diabetes mellitus was significantly higher than that in normal people (P <0.05). There was no significant change in true insulin and leptin, immunoreactive insulin / true insulin was significantly increased, and insulin sensitivity was decreased. There was a good positive correlation between normal immunoreactive insulin, true insulin, and leptin, but no correlation was found between those with type 2 diabetes and those with type 2 diabetes, all of which had a good correlation with immunoreactive insulin / true insulin (P <0 0 1). Normal and obese diabetic patients immunoreactive insulin, leptin are elevated, true insulin is normal. Conclusion Patients with type 2 diabetes have insulin resistance, relative deficiency of true insulin and imbalance of insulin leptin axis. Determining true insulin and immunoreactive insulin / true insulin is more clinically meaningful than measuring immunoreactive insulin alone to more accurately reflect beta-cell function. Obesity is an important cause of insulin resistance and leptin resistance