CAJ | 학술논문

　　目的探讨初发2型糖尿病（ T2DM）患者血胰高血糖素样肽-1（ GLP-1）对胰高血糖素及早相胰岛素分泌的影响。方法以新发T2DM患者（T2DM组）、健康体检者（对照组）为研究对象，采用标准馒头餐试验，观察空腹、进餐后30 min、120 min静脉血浆GLP-1动态变化及对血浆葡萄糖、胰高血糖素、胰岛素分泌的影响。结果初发T2 DM组患者馒头餐各时点GLP-1水平均分别较对照组显著降低，差异有统计学意义（ P＜0.05），馒头餐后30 min、120 min胰岛素水平显著降低（ P＜0.05），但空腹胰岛素无明显差异（ P＞0.05）；而胰高血糖素则较对照组各时点显著升高，差异有统计学意义（P＜0.05）。初发T2DM组早相胰岛素分泌指数（ΔFINS30/ΔG30）显著低于对照组，差异有统计学意义（P＜0.05）。结论初发T2DM患者存在GLP-1分泌减少，GLP-1缺乏可能是T2DM患者胰岛β细胞分泌缺乏及胰高血糖素分泌过多的重要因素。
　　목적탐토초발2형당뇨병（ T2DM）환자혈이고혈당소양태-1（ GLP-1）대이고혈당소급조상이도소분비적영향。방법이신발T2DM환자（T2DM조）、건강체검자（대조조）위연구대상，채용표준만두찬시험，관찰공복、진찬후30 min、120 min정맥혈장GLP-1동태변화급대혈장포도당、이고혈당소、이도소분비적영향。결과초발T2 DM조환자만두찬각시점GLP-1수평균분별교대조조현저강저，차이유통계학의의（ P＜0.05），만두찬후30 min、120 min이도소수평현저강저（ P＜0.05），단공복이도소무명현차이（ P＞0.05）；이이고혈당소칙교대조조각시점현저승고，차이유통계학의의（P＜0.05）。초발T2DM조조상이도소분비지수（ΔFINS30/ΔG30）현저저우대조조，차이유통계학의의（P＜0.05）。결론초발T2DM환자존재GLP-1분비감소，GLP-1결핍가능시T2DM환자이도β세포분비결핍급이고혈당소분비과다적중요인소。
Objective To explore the effects of the change of Glucagon-like peptide-1 level on glucagon and early phase insulin secretion in the patients with the newly diagnosed type 2 diabetes.Methods Patients with the newly diagnosed type 2 diabetes(T2DM group) and healthy volunteers(control group) were used as the research ob-ject, and the standardized bread meal test was used to observe effects of the dynamic changes of GLP -1 level at 0 min, 30 min and 120 min on plasma glucose , glucagon and insulin secretion .Results The levels of GLP-1 at each time point in newly diagnosed T2DM group were significantly reduced compared with those of the control group respec -tively(P<0.05);The levels of insulin at 30 min and 120 min were both significantly reduced compared with those of the control group respectively ( P <0.05 ) , but the difference had no statistical significance at 0 min between two groups(P>0.05);The levels of glucagon at each time point in newly diagnosed T 2DM group were significantly higher than that of the control group (P<0.05).The first-phase insulin secretion index of newly diagnosed T 2DM group was significantly reduced compared with those of the control group ( P<0.05 ) .Conclusion The levels of GLP-1 at each time point in newly diagnosed patients with type 2 diabetes mellitus were significantly reduced;GLP-1 dificiency might be the important factors of lack of islet beta cell secretion and insrease of glucagon secretion .