标题：不同糖耐量人群中胰岛素原、真胰岛素与胰岛β细胞功能的相关性研究

      作者：陆雷群，马晓英，陈 玲
    （上海交通大学附属瑞金医院卢湾分院内分泌科，上海 200020）

      卷次： 2013年24卷11期

      【摘要】 目的 探讨不同糖耐量人群中真胰岛素（TI）、胰岛素原（PI）与胰岛β细胞功能变化的临床意
义。方法 检测正常对照组（NGT）、糖耐量减退（IGT）组，糖尿病（DM）组各60例的空腹及2 h血糖、免疫反应性
胰岛素（IRI）、胰岛素原(PI)及真胰岛素(TI)，采用稳态模型(HOMA Model)评估法计算胰岛β细胞功能指数
(HOMA-β)和胰岛素抵抗指数(HOMA-IR)。结果 DM组的空腹PI水平、PI/IRI高于NGT组及 IGT组，同时其TI/
IRI低于NGT组及 IGT组，且 PI/IRI及 TI/IRI在各组间差异具有统计学意义(P<0.05)。β细胞功能指数由 IRI
计算HOMA-βIRI，在DM组低于 IGT组和NGT组(P<0.05)；由 TI计算的HOMA-βTI值，DM组和 IGT组低于
NGT组(P<0.05)。胰岛素抵抗指数无论是用 IRI还是用 TI计算的HOMA-IR均显示DM组>IGT组>NGT组
(P<0.05)。结论 T2DM患者测定PI、TI水平可能较 IRI更能反映胰岛β细胞水平和功能状况。

      【关键词】 胰岛素；胰岛素原；免疫反应性胰岛素；胰岛β细胞功能；HOMA-β；HOMA-IR

      【中图分类号】 R977.1+5 【文献标识码】 A 【文章编号】 1003—6350（2013）11—1622—03


Correlation between proinsulin, true insulin and islet cell function in people with different glucose tolerance.
LU
Lei-qun, MA Xiao-ying, CHEN Ling. Ruijin Hospital Luwan Branch Affiliated to Shanghai Jiao Tong University, Shanghai
200020, CHINA

【Abstract】 Objective To study the changes and significance of serum true insulin (TI), proinsulin (PI) and
immune reactive insulin (IRI) in patients with different glucose tolerance. Methods The levels of serum TI, PI, IRI
were tested by radioimmunoassay in 180 cases with different glucose tolerance, which were divided into normal con-
trol (NGT) group, abnormal glucose tolerance (IGT) group, diabetes mellitus (DM) group, with 60 cases in every
group. The HOMA-IR and HOMA-β were calculated and analyzed with Homeostasis Model Assessment (HOMA).
Results The fasting PI level and PI/IRI in DM group were higher than those in NGT and IGT group, and the TI/IRI
were lower than that in NGT and IGT group. PI/IRI and TI/IRI showed statistically significant difference between the
three groups (P<0.01). The HOMA-βIRI calculated by IRI in DM group was lower than that in IGT and NGT group
(P<0.05). The calculation of the TI HOMA-βTI value in DM and IGT group was lower than that in NGT group (P<
0.05). Insulin resistance index whether by IRI or by TI calculation HOMA-IR all showed that DM>IGT> NGT (P<
0.05). Conclusion Determination of PI and TI, instead of IRI level, may reflect the true level and function of islet
cells in patients with T2DM.

      【Key words】 Insulin; Proinsulin; Immunoreactivity Insulin; Beta cell function; HOMA-β; HOMA-IR
基金项目：上海市卢湾区科委课题（编号：LKW1103）