胰島素分泌與抗性：有無糖尿病或透析之比較

To Compare Insulin Secretion and Insulin Resistance: In Patients With or No Diabetic Nephropathy and Hemodialysis

蕭妏倩(Wen-Chien Hsiao) ； 潘華山(Hua-Shan Pan) ； 陳哩湘(Li-Hsiang Chen) ； 張光世(Kuang-Shih Chang) ； 蕭善良(Shan-Liang Hsiao) ； 蔡佳璋(Chia-Chang Tsai)

《腎臟與透析》 34卷2期 (2022/06) Pp. 102-106

https://doi.org/10.6340/KD.202206_34(2).0010

摘要

糖尿病腎病變患者胰島素的代謝能力較差，胰島素會蓄積在體內，延長降低血糖的能力。臨床觀察到糖尿病透析患者的血糖比未透析時有較好控制，引發探討血液透析對此類病人胰島素抗性的影響。本文分析血液透析者和非透析患者的檢驗數據。發現糖尿病透析組的C-胜肽明顯高於糖尿病非透析組者（9.56 ± 4.60 ng/ mL vs. 1.28 ± 0.80 ng/mL, p ＜ 0.001），且胰島素抵抗指數則明顯低於糖尿病非血液透析組（5.23 ± 5.78 vs 12.07 ± 12.4，p = 0.038）。結果顯示這些糖尿病透析患者自身分泌胰島素能力比較好。

關鍵字

胰島素抗性指數 ； 醣化血色素A1C ； C-胜肽 ； 糖尿病腎病變 ； 胰島素抗性

並列摘要

Patients with diabetic kidney disease (DKD) have poor insulin metabolism. Insulin will accumulate in the body and prolong the ability to lower blood sugar. It was observed that the blood glucose of diabetic patients on dialysis was better controlled than that of non-dialysis patients. This article analyzes the laboratory data of hemodialysis patients and non-dialysis patients. It was found that the C-peptide of the DKD dialysis group was significantly higher than that of the diabetic non-dialysis group (9.56 ± 4.60 ng/mL vs 1.28 ± 0.80 ng/mL, p ＜ 0.001), and the insulin resistance index as homeostasis model assessment of insulin resistance was significantly lower than that of the diabetic non-dialysis group (5.23 ± 5.78 vs 12.07 ± 12.4, p = 0.038). The results show that these diabetic dialysis patients have better ability to secrete insulin by themselves.

並列關鍵字

homeostasis model assessment of insulin resistance (HOMA-IR) ； hemoglobin A1C (HbA1C) ； C-peptide ； diabetic kidney disease ； insulin resistance