应用高胰岛素正葡萄糖钳夹技术评价我国LADA患者的胰岛素抵抗

目的应用高胰岛素正葡萄糖钳夹技术评估我国成人隐匿性自身免疫性糖尿病（LADA）患者的胰岛素抵抗。方法研究对象分为LADA组、2型糖尿病（T2DM）组、正常对照（NC）组。糖尿病患者均为初诊未治，经2周胰岛素强化治疗血糖控制达标后进行研究。对全部研究对象空腹测定临床参数及生化指标，应用高胰岛素正葡萄糖钳夹技术测定胰岛素敏感性指数（ISI）。结果LADA组FC-P及Fins显著低于NC组（P〈0．05），年龄、BMI、wHR、SBP、DBP、TC、TG、LDL—C、HDL-C与NC组比较，均无统计学差异。LADA组BMI、WHR、SBP、Fins、FC-P、TC、TG、LDL-C均显著低于T2DM组（P均〈0．05）。NC组、LADA组、T2DM组ISI分别为12．83±1．09、6．70±0．71、3．80±0．20，三组间比较有统计学差异（P〈0．05）。结论与NC组相比，LADA患者存在胰岛素抵抗，其程度较T2DM组轻。

Evaluation of the insulin resistance in latent autoimmune diabetes in adults of Chinese by euglycemic-hyperinsulinemic clamp

Objective To investigate the insulin resistance in latent autoimmune diabetes in adults （LADA）of Chinese by englycemic-hyperinsulinemic clamp. Methods Six cases of newly diagnosed LADA, 8 cases of newly diagnosed type 2 diabetes and 10 healthy volunteers （NC）were selected in the study. Their insulin sensitivity indexes （ISI, the average glucose infusion rate divided by the average insulin concentration during 120 to 150 minutes of euglycemic-hyperinsulinemic clamp, and then multiplied by 100） were evaluated after 2 weeks of insulin intensive treatment. Results Fasting C peptide （FC-P） and fasting insulin concentration （Fins） in LADA group were significantly lower than those in NC group, while age, body mass index（BMI）, waist-hip ratio （WHR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, total cholesterol （TC）, tfiglyceridies （TG）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C） were not significantly different between LADA and NC group. BMI, WHR, SBP, Fins, FC-P, TC, TG, LDL- C in LADA group were significantly lower than those in T2DM group. The ISI of NC, LADA, T2DM were 12. 83±1.09, 6.70 ± 0. 71, 3. 80 ± 0. 20, respectively. There was significant difference among three groups （all P〈0. 05）. Conclusions The insulin sensitivity index of Chinese LADA patients were significantly lower than that in NC group, but higher than that in T2DM group.