CAJ | 학술논문

目的探讨成人隐匿性自身免疫性糖尿病(LADA)和2型糖尿病(T2DM)一级亲属胰岛β细胞功能的变化. 方法对24例健康对照(NC)、28例谷氨酸脱羧酶抗体(GAD-Ab)阳性LADA一级亲属、14例羧基肽酶H抗体(CPH-Ab)阳性LADA一级亲属、15例T2DM一级亲属行纳格列奈-OGTT,比较其反映β细胞功能的相关指标. 结果①GAD-Ab阳性LADA一级亲属的胰岛素释放峰值、30min时的△I/△G、IRR、MVI、AUCIns较NC组降低(P<0.05～0.01);其HOMA-IR高于NC组(P<0.05);②T2DM一级亲属组的HOMA-IR高于NC组(P<0.05);③LADA一级亲属组中抗体阳性者的胰岛素释放峰值、30 min时的△I/△G、IRR及MVI较阴性者降低更明显;后者的HOMA-IR大于NC组(P<0.05). 结论 LADA一级亲属存在明显的早期相胰岛分泌与储备功能减退及IR,其中抗体阳性者以胰岛分泌功能缺陷为主伴IR,抗体阴性者以IR为主伴胰岛分泌功能缺陷;T2DM一级亲属存在明显的IR.
목적탐토성인은닉성자신면역성당뇨병(LADA)화2형당뇨병(T2DM)일급친속이도β세포공능적변화. 방법대24례건강대조(NC)、28례곡안산탈최매항체(GAD-Ab)양성LADA일급친속、14례최기태매H항체(CPH-Ab)양성LADA일급친속、15례T2DM일급친속행납격렬내-OGTT,비교기반영β세포공능적상관지표. 결과①GAD-Ab양성LADA일급친속적이도소석방봉치、30min시적△I/△G、IRR、MVI、AUCIns교NC조강저(P<0.05～0.01);기HOMA-IR고우NC조(P<0.05);②T2DM일급친속조적HOMA-IR고우NC조(P<0.05);③LADA일급친속조중항체양성자적이도소석방봉치、30 min시적△I/△G、IRR급MVI교음성자강저경명현;후자적HOMA-IR대우NC조(P<0.05). 결론 LADA일급친속존재명현적조기상이도분비여저비공능감퇴급IR,기중항체양성자이이도분비공능결함위주반IR,항체음성자이IR위주반이도분비공능결함;T2DM일급친속존재명현적IR.
Objective To assess islet beta-cell function in non-diabetic first-degree relatives of LADA and T2DM. Methods Nateglinide(NG)-OGTT was performed in 24 healthy volunteers, 28 first-degree relatives of LADA with GAD-Ab, 14 with CPH-Ab, 15 first-degree relatives of T2DM. Results ① During NG-OGTT, the insulin release peak value, △I 30min/△G 30min, IRR 30 min, MVI and AUCIns 30 min were decreased by 30.23%,44.86%,37.55%,51.19% and 25.12% (P<0.05～0.01) respectively and the HOMA-IR was higher(P<0.05) in first-degree relatives of LADA with GAD-Ab than in controls.②The HOMA-IR was higher(P<0.05)in first-degree relatives of T2DM than in control.③ The insulin release peak value, △I 30min/△G 30min, IRR 30min and MVI were 44.81% and 17.28%,43.93%and 43.46%, 49.28% and 29.50%,59.00% and 34.70% lower(P<0.05～0.01) respectively in first-degree relatives with and without islet autoantibodies than in controls.The HOMA-IR was higher(P<0.05) in first-degree relatives without islet autoantibodies. Conclusions Besides the obvious decrease of the early insulin release and maximally stimulated beta-cell capacity, there also exists IR in first-degree relatives of LADA.There exists serious IR in first-degree relatives of T2DM.In first-degree relatives with islet autoantibodies, the change in islet beta-cell function mainly involves early insulin release impairment with some IR as well.