摘要
目的 在国内建立检测胰岛素 (Ins)分泌功能的精确方法 :高葡萄糖钳制技术。 方法 对 2 5名居住上海地区的正常中国人 (男 16名 ,女 9名 )进行高葡萄糖钳夹实验。空腹平卧后两侧上肢静脉埋管。一侧持续输注 2 0 %葡萄糖溶液 ,通过负反馈调节机制使血糖始终维持在较基础血糖升高 7.9mmol/L的水平。另一侧静脉定时取血测定Ins水平 ,以获得双相Ins分泌值 ,评价胰岛 β细胞功能。 结果 (1)受试者血浆葡萄糖浓度在钳夹开始后的指定时间内 (14min)能达到实验所要求的高糖平台 [(12 .86± 0 .11)mmol/L] ,并能维持此水平至实验结束 ;(2 )在维持高糖平台期间 ,每 5min检测的血糖变异系数为 4.2 % ;(3 )可观察到持续高糖水平下双相Ins的分泌形态 ,第一时相Ins分泌为 (2 47.8± 2 3 .5)mU/L ,第二时相为 (72 .8± 6.1)mU/L。 (4)高糖钳夹可同时获得个体的Ins敏感性 (ISI) 19.9± 2 .4,但较正糖钳夹值为高。 结论 (1)成功建立了高葡萄糖钳夹技术 ,评价了正常个体的双相Ins分泌及最大Ins分泌。 (2 )高葡萄糖钳夹能同时了解机体的胰岛素抵抗 (IR)情况 。
ObjectiveTo establish hyperglycemic clamp tech ni que, a method for the precise measurement of insulin secretion.Methods Hyperglycemic clamp research were conducted on 25 normal glucose toler ance Chinese individuals from Shanghai, 16 men, and 9 women. The subjects were f asting. Intra-catheters were placed in both upper limbs veins. One side was for infusion of 20% glucose solution continually to keep plasma glucose 7.9 mmol/L higher than basic glucose state during the test by negative feedback principle. The other side was for the collection of blood samples to obtain insulin value a nd two-phases insulin secretion so as to evaluate β cell function.Re sults(1)The plasma glucose concentration of the individuals reached a hyperglycemic plateau in prescriptive time (14 minutes)(12.86±0.11 mmol/L)a nd kept the level during the whole test. (2)Throughout the hyperglycemic clamp process, the variance coefficient of plasma glucose which was determined every 5 minutes was 4.2%. (3)It was observed that two-phases of insulin secretions were present during persistent hyperglycemic state with phase 1 of (247.8±23 .5) mU/L, and phase 2 of (72.8±6.1) mU/L.(4)It was obtained that insulin sens itivity index (19.93±2.43) in hyperglycemic clamp was higher than that in eugl ycemic clamp.Conclusions(1)Hyperglycemic clamp technique i s established successfully . It may evaluate the two-phases insulin release and maximum insulin secretion in normal individuals. (2) Hyperglycemic clamp can also evaluate insulin resistance and observe the discrepancy of insulin sensitiv ity in different populations simultaneously.
出处
《中国糖尿病杂志》
CAS
CSCD
2004年第1期23-27,共5页
Chinese Journal of Diabetes
基金
上海市科技发展基金 ( 0 1 41 1 90 1 2 )
