Evaluation of β-cell function in diabetic Taiwanese children using a 6-min glucagon test
Evaluation of β-cell function in diabetic Taiwanese children using a 6-min glucagon test
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DOI：
10.1007/s00431-007-0594-9
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发表时间：
2008-07-01
影响因子：
3.6
通讯作者：
Hsiao, Pei-Hung
中科院分区：
文献类型：
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作者：
Tung, Yi-Ching;Lee, Jing-Sheng;Hsiao, Pei-Hung
本研究通过静脉给药前和给药后6分钟测定的C肽，评价胰高血糖素30 μ g/kg（最大1 mg）对儿童β细胞功能的影响。从1990年到2005年，118名新诊断糖尿病的台湾儿童（98名1型糖尿病儿童和20名2型糖尿病儿童）和29名正常台湾儿童入组本研究。分析空腹和6分钟后胰高血糖素C肽水平。在青春期前组中，1型糖尿病和正常儿童的中位空腹血清C肽水平分别为0.2和0.8 nmol/l。胰高血糖素刺激后，这些水平升高至0.3和1.9 nmol/l。在青春期组中，1型糖尿病、2型糖尿病和正常儿童的中位空腹血清C肽水平分别为0.3、1.0和0.9 nmol/l。在胰高血糖素刺激后，它们分别升高至0.4、2.5和2.7 nmol/l。1型糖尿病患儿空腹及胰高血糖素后C肽水平均显著低于正常儿童和2型糖尿病患儿。由接受操作特征曲线确定的区分1型糖尿病患者和2型糖尿病患者的最佳截止值分别为0.7和1.1 nmol/l。两个C肽值的灵敏度均为93%。胰高血糖素后C肽水平在区分1型糖尿病和2型糖尿病方面更有效，特异性更高（95% vs. 85%）。6分钟胰高血糖素试验在评估儿童β细胞功能方面很有价值，可以帮助儿科医生鉴别诊断儿童糖尿病。
This study evaluates the effects of glucagon 30 mu g/kg (maximal 1 mg) on beta-cell function in children by C-peptide determined before and 6 min after intravenous administration. From 1990 to 2005, 118 Taiwanese children with newly diagnosed diabetes mellitus (98 children with type 1 and 20 children with type 2) and 29 normal Taiwanese children were enrolled in this study. Fasting and 6-min post-glucagon C-peptide levels were analyzed. In the pre-pubertal group, the median fasting serum C-peptide levels were 0.2 and 0.8 nmol/l in type 1 diabetes and normal children, respectively. These levels rose to 0.3 and 1.9 nmol/l after glucagon stimulation. In the pubertal group, the median fasting serum C-peptide levels were 0.3, 1.0 and 0.9 nmol/l in type 1 diabetes, type 2 diabetes and normal children, respectively. They rose to 0.4, 2.5 and 2.7 nmol/l after glucagon stimulation. Both fasting and post-glucagon C-peptide levels in type 1 diabetes patients were significantly lower than those of normal children and children with type 2 diabetes. The optimal cut-off values to distinguish type 1 diabetes patients from those with type 2 as determined by the receiving operating characteristic curve were 0.7 and 1.1 nmol/l, respectively. The sensitivities of both C-peptide values were 93%. The post-glucagon C-peptide level was more powerful in distinguishing type 1 diabetes from type 2 diabetes with higher specificity (95% vs. 85%). The 6-min glucagon test is valuable in assessing beta-cell function in children and can help pediatricians in the differential diagnoses of diabetes mellitus in children.