摘要
目的研究肝移植受者移植术后的胰岛素分泌特点。方法根据75g葡萄糖耐量试验结果将60例肝移植受者分成为移植后糖耐量正常(PTNGT)组(n=24)、移植后糖耐量异常组(PTIGT,n=14)和移植后糖尿病组(PTDM,n=22)。采集PTNGT组、PTIGT组、PTDM组及正常组(NGT)的葡萄糖耐量试验及胰岛素释放试验结果。采用稳态模型评估法评估β细胞功能指数(HOMA-β)和胰岛素抵抗指数(HOMA-IR)。结果与NGT组相比,PTNGT组出现胰岛素分泌高峰延迟,并且PTNGT组的HBCI明显升高。PTNGT组、PTIGT组及PTDM组的HOMA-IR均明显高于NGT组(P<0.05),PTIGT组及PTDM组的HOMA-β明显低于NGT组(P<0.05)。结论 PTDM患者同时存在胰岛素抵抗及β细胞功能减退,肝移植后NGT患者已存在明显的胰岛素抵抗和代偿性胰岛素分泌增加和峰对后移,应对其采取相应干预措施。
Objective To study the characteristics of insulin secretion of post-liver transplantation diabetes mellitus. Methods 60 liver transplantation recipients were divided into three groups according to the results of 75g oral glucose tolerance test（OGTT） ： post-transplantation normal glucose tolerance（PTNGT）（n=24）,post-transplantation impaired glucose tolerance（PTIGT）（n=14）,and post-transplantation diabetes mellitus（PTDM）（n=22）.Insulin releasing test was performed in all the three groups,as well as in normal glucose tolerance patients without liver transplantation（NGT）group（n=20）.Insulin resistance and β-cell function were assessed by homeostasis model assessment（HOMA） method. Results Homeostasis model assessment-insulin secretion index（HOMA-β） in PTNGT group was significantly higher than in NGT group（P0.05）.Insulin secretion peak was significantly delayed in the PTNGT versus NGT group.HOMA-β was lower in either PTIGT group or PTDM group than in NGT and PT-NGT group（P0.05 respectively）.Homeostasis model assessment-insulin resistance（HOMA-IR） in PTNGT,PTIGT and PTDM group were higher than in the NGT group（P0.05 respectively）. Conclusion Both insulin resistance and β-cell dysfunction occur in PTDM patients.Insulin resistance and compensative insulin secretion increase have obviously existed in patients with normal plasma glucose after liver transplantation,which should be treated appropriately.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2012年第2期133-135,共3页
Chinese Journal of Diabetes
基金
武警总医院科研基金
关键词
胰岛素分泌
肝移植
器官移植术后糖尿病
胰岛素抵抗
Β细胞功能
Insulin secretion
Liver transplantation
Post-transplantation diabetes mellitus
Insulin resistance
Islet β-cell function
