Biological activity of C-peptide on the skin microcirculation in patients with insulin-dependent diabetes mellitus
Biological activity of C-peptide on the skin microcirculation in patients with insulin-dependent diabetes mellitus
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DOI：
10.1172/jci2147
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发表时间：
1998-05-15
影响因子：
15.9
通讯作者：
Pfützner, A
中科院分区：
文献类型：
--
作者：
Forst, T;Kunt, T;Pfützner, A
采用随机、双盲、交叉研究方法，对19例胰岛素依赖型糖尿病（IDDM）患者和10例健康志愿者进行了人C肽对皮肤微血管血流的影响。在静脉输注C肽（8 pmol kg（-1）min（-1））或生理盐水（154 mmol L（-1）NaCl）60 min期间以及停止输注后30 min，监测血压、心率、血糖和C肽水平。在同一时间段内，毛细血管血细胞流速（CBV），激光多普勒nux（LDF），皮肤温度进行了评估的脚。在verum组中，C肽水平在开始输注后增加，45分钟后达到最大值2.3+/-0.2 nmol L（-1），但在盐水治疗期间保持在0.15 nmol L（-1）以下。糖尿病患者的基线CBV低于健康受试者（147+/-3.6 vs. 162+/-4.2 μ m s（-1）; P < 0.01）。在C-肽给药期间，IDDM患者的CBV从147 ± 3.6 μ m s（-1）逐渐增加到167 ± 3.7 μ m s（-1，P < 0.001），而在生理盐水输注期间或在健康受试者中没有显著变化。与CBV测量相反，LDF、皮肤温度、血压、心率或血糖的调查在研究期间没有表现出任何显著的变化。在IDDM患者中，通过增加相对于乳头下动静脉分流的营养性CBV，人类C肽的替代导致皮肤微血管血流水平与健康受试者的水平相当的再分布。
19 insulin-dependent diabetes mellitus (IDDM) patients participated in a randomized double-blind crossover investigation to investigate the impact of human C-peptide on skin microvascular blood flow, The investigation was also carried out with 10 healthy volunteers. Blood pressure, heart rate, blood sugar, and C-peptide levels were monitored during a 60-min intravenous infusion period of C-peptide (8 pmol kg(-1) min(-1)) or saline solution (154 mmol liter(-1) NaCl), and 30 min after stopping the infusion. During the same time period, capillary blood cell velocity (CBV), laser Doppler nux (LDF), and skin temperature were assessed in the feet. In the verum arm, C-peptide levels increased after starting infusion to reach a maximum of 2.3+/-0.2 nmol liter(-1) after 45 min, but remained below 0.15 nmol liter(-1) during the saline treatment. Baseline CBV was lower in diabetic patients compared with healthy subjects (147+/-3.6 vs. 162+/-4.2 mu m s(-1); P < 0.01). During C-peptide administration, CBV in IDDM patients increased progressively from 147+/-3.6 to 167+/-3.7 mu m s(-1); P < 0.001), whereas no significant change occurred during saline infusion or in healthy subjects. In contrast to the CBV measurements, the investigation of LDF, skin temperature, blood pressure, heart rate, or blood sugar did not demonstrate any significant change during the study.Replacement of human C-peptide in IDDM patients leads to a redistribution in skin microvascular blood flow levels comparable to levels in healthy subjects by increasing the nutritive CBV relative to subpapillary arteriovenous shunt flow.