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目的 探讨 2型糖尿病人群基础及早期胰岛素分泌对血糖水平的贡献。方法 2型糖尿病患者 81例 ,测定标准餐试验 0、3 0、60、12 0min血浆葡萄糖及真胰岛素水平。计算胰岛素敏感性指数 (ISI)和早期胰岛素分泌 (ΔI3 0 /ΔG3 0 ) ,以评估机体胰岛素敏感性 ,以多因素回归方法评估早期及基础胰岛素分泌对2型糖尿病人群血糖变化的贡献。结果 多因素回归分析显示 ,ISI和ΔI3 0 /ΔG3 0 对血糖变化的贡献几乎相等。在标准餐试验各时点胰岛素值中 ,空腹及 60min血浆真胰岛素水平对血糖水平的变化起主要作用 ;空腹胰岛素对血糖曲线下面积的作用强于ΔI3 0 /ΔG3 0 的作用。结论 基础及早期胰岛素分泌对血糖水平的变化都有重要影响
Objective To investigate the basis of type 2 diabetes and the contribution of early insulin secretion to blood glucose levels. Methods Eighty-one patients with type 2 diabetes mellitus were enrolled in this study. The levels of plasma glucose and true insulin at 0, 30, 60 and 120 min were measured in the standard meal test. The insulin sensitivity index (ISI) and early insulin secretion (ΔI3 0 / ΔG3 0) were calculated to assess the body’s insulin sensitivity and the contribution of early and basal insulin secretion to the changes of blood glucose in type 2 diabetic patients was evaluated by multivariate regression. Results Multivariate regression analysis showed that the contribution of ISI and ΔI3 0 / ΔG3 0 to blood glucose changes were almost equal. Fasting and 60min plasma true insulin levels play a major role in the changes of blood glucose level at each time point of standard meal test. The effect of fasting insulin on blood glucose level is stronger than that of ΔI30 / ΔG30. Conclusion The basis and early insulin secretion have important influence on the changes of blood glucose level