题名：Assessment of beta-cell function in young patients with type 2 diabetes: arginine-stimulated insulin secretion may reflect beta-cell reserve.
作者：SJOSTRAND M; CARLSON K; ARNQVIST HJ; GUDBJORNSDOTTIR S; LANDIN-OLSSON M; LINDMARK S; NYSTROM L; SVENSSON MK; ERIKSSON JW; BOLINDER J;
来源：J Intern Med. 2014 Jan;275(1):39-48. [ IF= 0.00 ] ]
URL ：N U L L
摘要：OBJECTIVE: Simple methods for the evaluation of dynamic b-cell function in
epidemiological and clinical studies of patients with type 2 diabetes (T2D) are
needed. The aim of this study was to evaluate the dynamic beta-cell function in
young patients with T2D with different disease durations and treatments. METHODS:
Overall, 54 subjects with T2D from the Diabetes Incidence Study in Sweden (DISS)
and 23 healthy control participants were included in this cross-sectional study.
Beta-cell function was assessed by intravenous (i.v.) administration of arginine
followed by i.v. glucose. The acute insulin and C-peptide responses to arginine
(AIRarg and Ac-pepRarg, respectively) and to glucose (AIRglu and Ac-pepRglu,
respectively)were estimated.Homeostasis model assessment of b-cell
function(HOMA-b) andCpeptide assessments were also used for comparisons between
patients with T2D and control participants. RESULTS: AIRarg and Ac-pepRarg, but
not AIRglu and Ac-pepRglu, could differentiate between patients with different
disease durations. AIRglu values were 89% (P < 0.001) lower and AIRarg values
were 29% (P < 0.01) lower in patients with T2D compared with control
participants. HOMA-b and fasting plasma C-peptide levels did not differ between
the T2D and control groups. CONCLUSION: In young patients with T2D, the insulin
secretory response to i.v. glucose is markedly attenuated, whereas i.v.
arginine-stimulated insulin release is better preserved and can distinguish
between patients with different disease duration and antidiabetic therapies. This
suggests that the i.v. arginine stimulation test may provide an estimate of
functional beta-cell reserve.