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顾金金, 赵铁耘, 刘云慧等. 不同糖代谢人群胰高血糖素水平的动态变化[J]. 四川大学学报（医学版）, 2014, 45(3): 428-431.
引用本文: 顾金金, 赵铁耘, 刘云慧等. 不同糖代谢人群胰高血糖素水平的动态变化[J]. 四川大学学报（医学版）, 2014, 45(3): 428-431.
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GU Jin-jin, ZHAO Tie-yun, LIU Yun-hui.et al. Changes of Plasma Glucagon Level in Individuals with Different Glucose Metabolism[J]. Journal of Sichuan University (Medical Sciences), 2014, 45(3): 428-431.
Citation: GU Jin-jin, ZHAO Tie-yun, LIU Yun-hui.et al. Changes of Plasma Glucagon Level in Individuals with Different Glucose Metabolism[J]. Journal of Sichuan University (Medical Sciences), 2014, 45(3): 428-431.
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不同糖代谢人群胰高血糖素水平的动态变化

Changes of Plasma Glucagon Level in Individuals with Different Glucose Metabolism

    摘要
  • 摘要: 目的 探讨不同糖代谢人群胰高血糖素水平的动态变化及影响因素。 方法 110例受试者，按75 g葡萄糖口服葡萄糖耐量试验 （OGTT）结果分为3组：正常糖耐量 （NGT）组33例，糖调节受损 （IGR）组35例，初诊2型糖尿病 （DM2）组42例。分别用放免法和电化学发光法测空腹、糖负荷后30 min、1 h、2 h的胰高血糖素 （GLC）和胰岛素 （INS）。并计算胰高血糖素曲线下面积 （AUCglc）、早相胰高血糖素分泌指数 （ΔGLC=GLC0.5 h-GLC0 h）、各时点胰岛素与胰高血糖素比值 （INS/GLC）。 结果 3组空腹GLC差异均无统计学意义 （P>0.05）。IGR组与NGT组比较，GLC0.5 h、GLC1 h、AUCglc和ΔGLC均升高，差异有统计学意义 （P<0.05）；INS0.5 h/GLC0.5 h下降，差异有统计学意义（P<0.05）。DM2组与NGT组比较，GLC0.5 h、GLC1 h、AUCglc和ΔGLC均升高，差异均有统计学意义 （P<0.05）；INS0.5 h/GLC0.5 h、INS1 h/GLC1 h均下降，差异均有统计学意义 （P<0.05）。DM2组与IGR组比较，GLC1 h、AUCglc均升高，差异有统计学意义（P<0.05）；INS0.5 h/GLC0.5 h、INS1 h/GLC1 h和INS2 h/GLC2 h均下降，差异均有统计学意义（P<0.05）。多因素相关分析显示：AUCglc与胰岛素抵抗指数 （HOMA-IR）呈正相关 （P=0.001）。 结论 本研究提示，3组人群空腹GLC水平没有明显差异，但糖负荷后 IGR组的GLC分泌亢进已经出现，胰岛素对GLC的抑制作用已经下降，且从NGT向DM2的发展过程中，糖负荷后GLC分泌亢进逐渐加重。HOMA-IR是GLC分泌亢进的重要因素。

     

    Abstract: Objective To determine the levels of plasma glucagon and associated factors in individuals with different glucose metabolism. Methods One hundred and ten outpatient patients received an oral glucose tolerance test (OGTT) voluntarily. The patients were divided into three groups according to their OGTT results: normal glucose golerance (NGT) group (n=33), impaired glucose regulation (IGR) group (n=35), newly diagnosed type 2 diabetes (DM2) group (n=42). Plasma glucagon (GLC) and insulin (INS) at 0 min (0 h), 30 min (0.5 h), 60 min (1 h) and 120 min (2 h) were measured by radio immunity and electrochemiluminescence assay, respectively. We calculated the area of glucagon under the curve (AUCglc), the value of early phase glucagon secretion （ΔGLC=GLC0.5 h-GLC0 h）and the ratio of insulin to glucagon (INS/GLC). Results ① There was no significant difference in the level of GLC0 h among the three groups (P>0.05). ② Patients in the IGR group had higher levels of GLC0.5 h and GLC1 h, greater values of AUCglc and ΔGLC, and lower values of INS0.5 h/GLC0.5 h than those in the NGT group (P<0.05). ③ Patients in the DM2 group had higher levels of GLC0.5 h and GLC1 h, greater values of AUCglc and ΔGLC, and lower values of INS0.5 h/GLC0.5 h and INS1 h/GLC1 h than those in the NGT group (P<0.05). ④ Patients in the DM2 group had higher levels of GLC1 h, greater values of AUCglc, and lower values of INS0.5 h/GLC0.5 h, INS1 h/GLC1 h, and INS2 h/GLC2 h than those in the IGR group (P<0.05). ⑤The multiple linear regression analysis showed that the value of AUCglc was positively correlated with HOMA-IR (adjust R 2/sup>=0.219, P=0.001). Conclusion There are no significant differences in fasting plasma glucagon levels among the individuals with different glucose metabolism. Hypersecretion of glucagon and reduced glucagon suppressing effect of insulin occur in IGR patients, which is exacerbated when DM2 are developed. HOMA-IR is an important factor associated with glucagon hypersecretion.

     

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