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目的 通过放免测定方法了解 2型 DM患者 GH/ IGF- I轴的改变与 1型 DM患者有何不同。方法 对 19例1型 DM和 98例 2型 DM患者的血清基础 GH及 IGF- I浓度进行测定。将 2型 DM患者血清 IGF- I浓度与其各项临床及生化指标进行多元相关回归分析。结果 1型 DM患者 GH水平 (2 .5 3± 0 .5 1μg/ L )明显高于对照组 (1.36± 0 .2 7μg/L ,P <0 .0 5 ) ;IGF- I水平 (191.5± 14.1μg/ L )则显著低于对照组 (2 6 6 .3± 17.7μg/ L ,P <0 .0 1)。2型 DM患者 GH(0 .6 0± 0 .11μg/ L)水平与对照组 (0 .74± 0 .0 7μg/ L)无显著性差异 (P >0 .0 5 ) ,IGF- I(12 6 .1± 3.2 μg/ L)水平较正常 (15 3.4±8.3μg/ L)明显降低 (P <0 .0 5 )。 2型 DM患者血清 IGF- I浓度与年龄 (P <0 .0 5 )及 Hb A1 c(P <0 .0 5 )呈负相关 ,与平均动脉压 (P<0 .0 5 )和空腹胰岛素 (P<0 .0 1)呈正相关。结论 2型 DM患者血清基础 GH和 IGF- I改变与 1型 DM患者有所不同 ,这种异常改变可能与持续高血糖水平有关。
OBJECTIVE: To determine whether GH / IGF- I axis changes in patients with type 2 DM differ from those in patients with type 1 DM by radioimmunoassay. Methods Serum levels of basal GH and IGF-I in 19 patients with type 1 DM and 98 patients with type 2 DM were measured. Multivariate regression analysis of serum IGF-I levels in type 2 DM patients and their clinical and biochemical parameters were performed. Results The level of GH in type 1 DM patients was significantly higher than that in control group (2.36 ± 0.27μg / L, P <0.05), IGF-I level (191.5 ± 14.1μg / L) was significantly lower than the control group (26.3 ± 17.7μg / L, P <0.01). There was no significant difference in GH (0.600 ± 0.11 μg / L) between type 2 DM patients and controls (0.74 ± 0. 0 7 μg / L) (P> 0.05) 12 6 .1 ± 3.2 μg / L) was significantly lower than the normal (15 3.4 ± 8.3 μg / L) (P <0.05). Serum IGF-I levels in type 2 DM patients were negatively correlated with age (P <0.05) and Hb A1c (P <0.05), but not with mean arterial pressure (P <0.05) and fasting insulin (P <0. 01) was positively correlated. Conclusions The changes of serum basal GH and IGF-I in patients with type 2 DM are different from those in patients with type 1 DM. The abnormal changes may be related to the sustained hyperglycemia.