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观察了2型糖尿病患者(DM)血清免疫反应性胰岛素(IRI)、真胰岛素(TI)和瘦素(LEP)之间的调节失衡现象。分别用放免法和BA-ELISA法测定39例2型DM患者和31名对照者IRI、TI和LEP水平,并分析三者之间的相互关系。2型DM组IRI(16.87±1.22 mIU/L)较对照组(12.33±1.31 mIU/L)明显增高(P<0.05),IRI/TI明显增高(11.10±1.98),胰岛素敏感性指数下降。对照组IRI、TI和LEP之间有很好的正相关性(r值:IRI与TI为0.553,IRI与LEP为0.631,LEP与TI为0.483;P均<0.001),2型DM组三者间则未见明显相关性。提示:正常人群IRI、TI和LEP之间有很好的互调作用,而2型DM患者存在着胰岛素抵抗(IR)、TI相对不足和胰岛素-LEP轴的平衡失调。
The regulatory imbalance between serum immunoreactive insulin (IRI), true insulin (TI) and leptin (LEP) was observed in patients with type 2 diabetes mellitus (DM). The levels of IRI, TI and LEP in 39 patients with type 2 DM and 31 controls were determined by radioimmunoassay and BA-ELISA, respectively. The correlations among them were analyzed. Compared with the control group (12.33 ± 1.31 mIU / L), the IRI of type 2 DM group (16.87 ± 1.22 mIU / L) was significantly higher (P <0.05) and IRI / TI was significantly higher (11.10 ± 1.98), insulin sensitivity index decreased. There was a good positive correlation between IRI, TI and LEP in the control group (r values: 0.553 for IRI and TI, 0.631 for IRI and LEP, 0.483 for LEP and TI; all P <0.001) There was no obvious correlation between them. It is suggested that there is a good intermutative effect between IRI, TI and LEP in normal subjects, whereas type 2 diabetic patients have imbalance of insulin resistance (IR), TI relative deficiency and insulin-LOP axis.