CAJ | 학술논문

目的评价1例Prader-Willi综合征患者的胰岛素敏感性.方法 1例18岁男性患者因体重进行性增加15年就诊,临床确诊为Prader-Willi综合征.对患者进行系统的内分泌检查并行高胰岛素正葡萄糖钳夹试验,评价患者的胰岛素敏感性.结果患者身高156 cm,体重115 kg,体质指数(BMI)47.3 kg/m2;糖化血红蛋白6.8％,2次口服葡萄糖耐量试验(OGTT)均达到糖尿病的诊断标准,同步胰岛β细胞功能评价提示晚时相胰岛素分泌高峰延迟.胰岛素:0 min 43.7 mU/L,1h247.6 mU/L,2 h 230.9 mU/L.甲状腺功能、肾上腺皮质功能均正常.钳夹试验时基础血浆葡萄糖为4.5 mmol/L,钳夹开始20～ 120 min内葡萄糖输注率(GIR)为6.6 mg/(kg·min),稳态期GIR为6.2 mg/( kg·min).结论 Prader-Willi综合征患者存在胰岛素抵抗.
목적 평개1례Prader-Willi종합정환자적이도소민감성.방법 1례18세남성환자인체중진행성증가15년취진,림상학진위Prader-Willi종합정.대환자진행계통적내분비검사병행고이도소정포도당겸협시험,평개환자적이도소민감성.결과 환자신고156 cm,체중115 kg,체질지수(BMI)47.3 kg/m2;당화혈홍단백6.8％,2차구복포도당내량시험(OGTT)균체도당뇨병적진단표준,동보이도β세포공능평개제시만시상이도소분비고봉연지.이도소:0 min 43.7 mU/L,1h247.6 mU/L,2 h 230.9 mU/L.갑상선공능、신상선피질공능균정상.겸협시험시기출혈장포도당위4.5 mmol/L,겸협개시20～ 120 min내포도당수주솔(GIR)위6.6 mg/(kg·min),은태기GIR위6.2 mg/( kg·min).결론 Prader-Willi종합정환자존재이도소저항.
Objective To evaluate the insulin sensitivity in a patient with Prader-Willi syndrome.Methods A 18-year-old man presented with progressive weight gain for 15 years was diagnosed as PraderWilli syndrome.Hyperinsulinemic-euglycemic clamp was performed to evaluate the insulin sensitivity in this patient.Results On admission,the patient' s body weight and height was 115 kg and 156 cm respectively,and his body mass index (BMI) was 47.3 kg/m2.The glycated hemoglobin (HbA1c) level was 6.8％.The results of oral glucose tolerance tests (OGTY) met the diagnostic criteria for diabetes mellitus.A delay peak of late-phase insulin secretion was found during OGTT:insulin level at 0,60 and 120 win was 43.7,247.6 and 230.9 mU/L,respectively.Thyroid and adrenal cortex function were all normal.In euglycemic clamp,the basal plasma glucose was 4.5 mmol/L,glucose infusion rate (GIR) was 6.6 and 6.2 mg/( kg · min)during 20 ～ 120 min and in stable phase,respectively.Conclusion It showed that Prader-Willi syndrome is associated with insulin resistance.