肥胖症患者和新诊断的2型糖尿病患者真胰岛素和前胰岛素的改变

目的 了解真胰岛素（ｔｒｕｅ ｉｎｓｕｌｉｎ，ＴＩ）和前胰岛素（ｐｒｏｉｎｓｕｌｉｎ，ＰＩ）在肥胖症和２型糖尿病患者中的改变，了解免疫活性胰岛素（ｉｍｍｕｎｏｒｅａｃｔｉｖｅ ｉｎｓｕｌｉｎ，ＩＲＩ）能否准确反映ＴＩ。方法 ３３例糖耐量正常（ＮＧＴ），２４例糖耐量减低（ＩＧＴ）和５３例新诊断的２型糖尿病患者行口服葡萄糖耐量实验，并根据体重指数（ＢＭＩ）分为肥胖和非肥胖组；采用ＥＬＩＳＡ方法（其单克

Plasma true insulin and proinsulin in obese and newly diagnosed type 2 diabetic patients

Objective To study the changes of true insulin (TI) and proinsulin (PI) in obesity and type 2 DM patients and to study the validity of immunoreactive insulin (IRI) in reflection of the level of insulin.Methods 33 cases with normal glucose tolerance (NGT),24 cases with impaired glucose tolerance (IGT) and 53 cases with newly diagnosed type 2 DM were subdivided into obese and non-obese groups.TI and PI were measured by ELISA using monoclonal antibody with no significant cross-reaction between insulin and proinsulin.IRI was measured routinely.Results Fas ting ,30 min,60 min and 120 min TI after a glucose loading in obese group with NGT were significantly higher than those in non-obese group with NGT.30 min and 60 min TI in non-obese group with DM were significantly lower than those in non-obese group with NGT.Fasting and 120 min TI in obese group with DM were significantly higher than those in non-obese group with NGT.30 min TI in non-obese group with IGT was significantly lower than that in non-obese group with NGT.120 min TI in obese group with IGT was significantly higher than that in non-obese group with NGT.Fasting PI/IRI in obese and non-obese group with DM was significantly higher than that in non-obese group with NGT.Fasting TI/IRI among obese group with NGT,non-obese group with DM,obese group with DM and obese group with IGT were significantly higher than that in non-obese group with NGT.Conclusion The individuals with obesity,obese IGT and obese newly diagnosed type 2 DM have true hyperinsulinemia.The patients with type 2 DM have disproportionally increased PI/IRI.IRI may overestimate insulin levels in individuals with obesity,type 2 DM and IGT.