胰高血糖素对2型糖尿病病人血浆生长激素释放肽的影响

目的 探讨外源性胰高血糖素对2型糖尿病(T2DM)病人生长激素释放肽(ghrelin)分泌的影响.方法 研究对象为2006年5月至2007年12月汕头大学医学院第一附属医院门诊和住院治疗T2DM病人38例(T2DM组),正常健康人(NC组)30名行胰高血糖素-C肽释放试验,同步取血测定血浆ghrelin、C肽.结果 (1)两组空腹C肽差异无统计学意义;静脉注射胰高血糖素6 min后:两组C肽均比空腹明显升高,差异有统计学意义T2DM组:(2.0±0.8)μg/L比(1.3±0.6)μg/L,NC组:(3.0±0.8)μg/L比(1.2±0.4)μg/L,均P<0.01],但T2DM组仍低于NC组;两组ghretin均有下降,NC组ghretin比空腹下降显著(2.3±0.7)μg/L比(2.7±0.8)μg/L,P<0.01),T2DM组ghrelin无明显下降(2.9±0.9)μg/L比(3.0±1.0)μg/L],差异无统计学意义(P>0.05);(2)空腹血浆ghrelin水平与腰围呈负相关(r=0.343,P<0.01),是它的独立预测因子.结论 ghrelin分泌可能与T2DM病人胰岛β细胞功能减退及早相胰岛素分泌缺陷有关;胰岛素、胰高血糖素及ghrelin可能相瓦作用影响糖调节.

Effects of glucagon on plasma ghrelin level in type 2 diabetes mellitus

Objective To investigate the effect of glucagon on ghrelin seretion in type 2 diabetes mellitus(T2DM)patients.Methods Circulating ghrelin and C-pepetide were measured during glucagon stimulation test in 38 cases with T2DM and 30 cases in normal controls(NC)at the 1st Affiliated Hospital of Shantou University from May 2006 to December 2007.Results(1)There w88 no significant difference in the fasting C-peptide and fasting ghrelin levels of the NC group were(1.3±0.6)μg/L and(3.0±1.0)ng/ml respectively,both not significantly different from those of the T2DM group(1.2±0.4)μg/L and (2.7±0.8)μg/L respectively,P>0.05 and P>0.05];six minutes after the injection of glucagon,the C-peptide level of the T2DM group increased to(2.0±0.8)μg/L(P<0.01),and that of the NC group increased to(3.0±0.8)μg/L(P<0.01),and the C-peptide level 6 min after of the T2DM group was significantly lower than that of the NC group(P<0.01).The ghrelin level 6 min after the injection of glucagon of the NC group wss(2.3±0.7)μg/L,significantly lower than that before the injection(P<0.01).But the ghrelin level 6 min after the injection of glucagon of the T2DM group was(2.9±0.9)μg/L,NOT significantly different from that before the injection(P>0.05).(2)Fasting ghrelin level was significantly negatively correlated with the waist circumference(r=0.343,P<0.05).Conclusion In healthy subjects exogenous slucagon decreases the ghrelin level.Ghrelin may be associated with the beta-cell hypofunetion and first-phase insulin socretion defects in T2DM.Insulin,glucagon,and ghretin secreted influence each other to regulate glucose homeostasis.