Increment of serum C-peptide measured by glucagon test closely correlates with human relative beta-cell area
Increment of serum C-peptide measured by glucagon test closely correlates with human relative beta-cell area
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DOI：
10.1507/endocrj.ej14-0456
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发表时间：
2015-04-20
影响因子：
2
通讯作者：
Shimomura, Iichiro
中科院分区：
文献类型：
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作者：
Fujita, Yukari;Kozawa, Junji;Shimomura, Iichiro
胰腺β细胞质量有助于葡萄糖耐量。本研究的目的是评估人β细胞质量与各种临床参数（包括胰岛素分泌能力）之间的关系。该研究包括32名日本患者，他们接受了胰腺切除术，并首次接受口服降糖药和胰岛素治疗。将其分为糖耐量正常组（n=13）、糖耐量减低组（n=9）和糖尿病组（n=10），评价其胰岛素分泌能力和胰岛素抵抗。使用免疫组织化学测定相对β细胞面积（%），其代表胰岛素阳性细胞面积与整个胰腺切片的比例。胰高血糖素试验C肽免疫反应性水平升高（δ C肽，静脉注射1 mg胰高血糖素后6分钟血清C肽增量[nmol/L]; r=0.64，p=0.002），β细胞功能的稳态模型评估（HOMA-β，空腹免疫反应性胰岛素[mu IU/mL] x 20 /（空腹血糖[mmol/L] - 3.5）; r=0.50，p=0.003），C肽指数（CPI，空腹C肽[nmol/L] /空腹血糖[mmol/L]; r=0.36，p=0.042），空腹免疫反应性胰岛素（F-IRE [pmol/L]; r=0.36，p=0.044）与相对β细胞面积显著正相关。75 g-OGTT的0 - 120 min血浆葡萄糖水平曲线下面积（AUC（0-120））也与相对β细胞面积显著负相关（r=-0.36，p=0.045）。逐步多元回归分析确定Delta C肽是相对β细胞面积的唯一独立和显著决定因素。结论：Delta C肽、HOMA β、CPI、F-IRE和AUC（0-120）与β细胞相对面积密切相关，Delta C肽是预测β细胞相对面积最有价值的指标。
Pancreatic beta-cell mass contributes to glucose tolerance. The aim of this study was to evaluate the relationships between human beta-cell mass and various clinical parameters, including insulin secretory capacity. The study included 32 Japanese patients who underwent pancreatectomy and were naive to oral hypoglycemic agents and insulin. They were classified into those with normal glucose tolerance (n=13), impaired glucose tolerance (n=9) and diabetes (n=10), and their insulin secretory capacity and insulin resistance were evaluated. Immunohistochemistry was used to determine relative beta-cell area (%) which represented the proportion of insulin-positive cell area to whole pancreatic section. Increment of C-peptide immunoreactivity level by glucagon test (Delta C-peptide, increment of serum C-peptide [nmol/L] at 6 min after intravenous injection of 1-mg glucagon; r=0.64, p=0.002), homeostasis model assessment of beta-cell function (HOMA-beta, fasting immunoreactive insulin [mu IU/mL] x 20 / (fasting plasma glucose [mmol/L] - 3.5); r=0.50, p=0.003), C-peptide index (CPI, fasting C-peptide [nmol/L] / fasting plasma glucose [mmol/L]; r=0.36, p=0.042), and fasting immunoreactive insulin (F-IRE [pmol/L]; r=0.36, p=0.044) correlated significantly and positively with the relative beta-cell area. The area under the curve of plasma glucose level from 0 to 120 min by 75 g-OGTT (AUC(0-120)) also correlated significantly and inversely with the relative beta-cell area (r=-0.36, p=0.045). Stepwise multiple regression analysis identified Delta C-peptide as the only independent and significant determinant of the relative beta-cell area. We conclude that Delta C-peptide, HOMA-beta, CPI, F-IRE and AUC(0-120) correlated closely with the relative beta-cell area, and Delta C-peptide was the most valuable index for the prediction of the area.