胰岛素抵抗和胰岛B细胞功能-第三军医大学学报.DOCVIP

胰岛素原和胰淀素原水平与胰岛素抵抗和胰岛β细胞功能的相关性研究 郑晓雅，任 伟，张素华，阳 萍 （400016 重庆 重庆医科大学附属第一医院内分泌ssociation of serum proinsulin with insulin resistance, and serum proamylin with islet beta cell function Zheng Xiaoya, Ren Wei, Zhang Suhua, Yang Ping (Department of Endocrinology, First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China) 【Abstract】 Objective To study the serum levels of proinsulin (PI), insulin (INS). proamylin (PA) and amylin (AMY) in abnormal glucose metabolism individuals and to explore the relationship between PI and insulin resistance (IR) and between PA and islet beta cell function. Methods Totally 69 subjects who received Oral glucose tolerance test (OGTT) and insulin release test in our department from March to May 2008 were divided into 4 groups according to the results of OGTT, that is, normal group, impaired glucose regulation (IGR) group，T2DM 1fasting blood-glucose (FBG)10 mmol/L] group, and T2DM 2 (FBG15mmol/L) group. All subjects underwent examination of anthropometry and serum bio-chemical indicators, HOMA-IR and HOMA-B were calculated. Results No significant difference wwas found in the serum levels of PI or AMY among the 4 groups, but the level of PA, PI/INS and PA/AMY among the 4 groups did have significant differences (P0.01). HOMA-IR was significantly influenced by PI and PI/INS, (P0.01) and HOMA-B was significantly influenced by PA and PA/AMY (P0.01). Conclusion Pro-insulin may be very important in the process of IR, while pro-amylin may exert considerable effect on islet B cells’ dysfunction. 【Key words】 type 2 diabetes; proinsulin; proamylin; amylin; insulin resistance 2型糖尿病（T2DM）是复杂的多基因遗传病，其发病机制至今未明。目前研究认为T2DM的发病与胰岛素抵抗（IR）和胰岛素分泌缺陷有关。Kim等[1]认为胰岛素原以及胰岛素原/胰岛素（PI/INS）比值是反映IR或胰岛β细胞功能的很好指标。在T2DM患者中胰岛素原以及胰岛素原/胰岛素（PI/INS）比值是显著增高的，但增高的机制并不明确，可能与胰岛素原的加工障碍有关。 【基金项目】 重庆市卫生局医学科学研究基金(2008-2-96)；重庆医科大学附属第一医院医学科学基金资助(YXJJ2009-03) Supported by the Medical Science Research Fund of Chongqing Municipal Health B