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目的:本研究拟在探讨诺和龙试验能否临床用于评价胰岛β细胞,以替代D860胰岛素释放试验。方法:分别检测662例2型糖尿病患者空腹及口服诺和龙后30min,60min,120min及180min的血糖,胰岛素水平的变化(应用外源性胰岛素的患者,检测C肽水平),结果:(1)在NT2DM与PT2DMA组F1NS/FPG水平明显高于T1DM与PT2DMC组,差异有统计学意义(P<0.05),但空腹C肽及C肽/空腹血糖在各组间差异无统计学意义。(2)口服诺和龙2毫克后,PT2DMC组没有胰岛素及C肽的快速分泌,其余各组在口服诺和龙后,胰岛素水平,胰岛素/血糖(I/PG)水平均在30min达到高峰,峰值在NT2DM,PT2DMA显著高于T1DM及PT2DMC组(P<0.01)。(3)口服诺和龙后30min胰岛素/血糖增值(△I30/△P30),胰岛素曲线下面积(AUCl),血糖校正后的胰岛素曲线下面积(AUCI/P),3h胰岛素净增值(△I/PG),HOMAβ,胰岛β细胞功能指数(MBCl),胰岛素抵抗指数(Homar-IR),胰岛素敏感指数(IAI)在NT2DM组明显高于T1DM及PT2DMC组(均P<0.05),同时,HOMAβ,△I30,AUCI,ACCI/P及△I/PG在PT2DMA组明显高于T1DM及PT2DMC组(P<0.05),△I30,AUCI,△I/PG在NT2DM组及T2DMB组之间也有显著性差异,(P<0.01)。结论:(1)诺和龙实验可以用来评估不同糖代谢紊乱状态人群胰岛β细胞功能,特别是空腹血糖明显升高的10年之内的2型糖尿病患者胰岛β细胞功能。(2)诺和龙口服后△I30/△P30,AUCI,ACCI/P,△I/P,HOMAβ,MBCI,Homar-IR,IAI均可以作为评价胰岛β细胞功能的指标,其中以HOMAβ,△I30,AUCI,ACCI/P及△I/PG为佳。
OBJECTIVE: This study intends to explore whether Novolin’s test can be used clinically to evaluate pancreatic β-cells in lieu of the D860 insulin release test. Methods: The changes of blood glucose and insulin levels at 30min, 60min, 120min and 180min after fasting and oral administration of Norovirus in 662 patients with type 2 diabetes mellitus were detected. The levels of C-peptide were measured in patients with exogenous insulin ) The level of F1NS / FPG in NT2DM and PT2DMA groups was significantly higher than that in T1DM and PT2DMC groups (P <0.05). However, there was no significant difference in fasting C-peptide and C-peptide / fasting plasma glucose between the two groups. (2) There was no rapid secretion of insulin and C-peptide in PT2DMC group after oral administration of 2 mg of Novolin, and the other groups reached the peak at 30 min after oral administration of Novolin, with the levels of insulin and insulin / blood glucose (I / PG) The peak values of NT2DM and PT2DMA were significantly higher than those of T1DM and PT2DMC groups (P <0.01). (3) The value of AUCI, AUCI / P and the value of 3-h insulin increase (△ I30 / △ P30), the area under the curve of insulin / PG), HOMAβ, MBC, Homar-IR and IAI in NT2DM group were significantly higher than those in T1DM and PT2DMC group (all P <0.05). Meanwhile, HOMAβ , △ I30, AUCI, ACCI / P and △ I / PG in PT2DMA group were significantly higher than those in T1DM and PT2DMC groups (P <0.05). △ I30, AUCI and △ I / PG were also significantly different between NT2DM group and T2DMB group Difference, (P <0.01). CONCLUSIONS: (1) Novozymes can be used to evaluate the function of islet β cells in patients with different glycometabolism disorders, especially in patients with type 2 diabetes mellitus within 10 years after fasting blood glucose significantly increased. (2) △ I30 / △ P30, AUCI, ACCI / P, △ I / P, HOMAβ, MBCI, Homar-IR and IAI after oral administration of Novolin can be used as indicators to evaluate the function of pancreatic β cells. I30, AUCI, ACCI / P and ΔI / PG are preferred.