糖尿病患者胰高血糖素水平变化及其临床意义

观察了糖尿病患者空腹及馒头餐后血浆胰高血糖素水平的变化。结果表明,胰岛素依赖型糖尿病(IDDM)及非胰岛素依赖型糖尿病(NIDDM)患者空腹胰高血糖素水平均显著高于正常人。NIDDM患者馒头餐后胰高血糖素水平显著升高,且于各时相均显著高于正常人,胰岛素/胰高血糖素比值的升高幅度则显著低于正常人。提示,糖尿病患者存在胰岛A细胞功能障碍。

CHANGES IN PLASMA GLUCAGON LEVEL IN DIABETIC PATIENTS AND THEIR CLINICAL SIGNIFICANCE

The fasting plasma glucagon level was measured in 39 normal subjects, 13 IDDM and 44 NIDDMpatients. The results showed that the glucagon level in both IDDs and NIDDs was significantly higherthan that in normal subjects (P<0.001). In addition, 18 normal subjects and 30 NIDDM patientsunderwent a steamed-bread meal test, and the changes in glucagon level was also studied. The glucagonlevel in NIDDM patients was significantly elevated after the meal (P<0.05 or less), but in normalsubjects there was no significant change (P>0.05). Whereas the glucagon levels before and after themeal in NIDDs were significantly higher than those in normal subjects (P<0.05 or less). The rise ofinsulin/glucagon ratio in NIDDs was retarded and much lower that that in normal subjects (P<0.01 orless) The results indicate that there exists dysfunction of islet a-cells in diabetic patients, and it maycontribute to hyperglycemia. Insulin/glucagon ratio may be a more perfect index than sole insulin me-asurement in reflecting the pathophysiological state of diabetes mellitus.