Chronic sulfonylurea treatment and hyperglycemia aggravate disproportionately elevated plasma proinsulin levels in patients with type 2 diabetes

被引：19

作者：

Inoguchi, T ^{[1
]}

Umeda, F ^{[1
]}

Kakimoto, M ^{[1
]}

Sako, Y ^{[1
]}

Ishii, H ^{[1
]}

Noda, K ^{[1
]}

Kunisaki, M ^{[1
]}

Imamura, M ^{[1
]}

Yu, HY ^{[1
]}

Etoh, T ^{[1
]}

Yoshikawa, H ^{[1
]}

Aoki, T ^{[1
]}

Hashimoto, T ^{[1
]}

Nawata, H ^{[1
]}

机构：

[1] Kyushu Univ, Grad Sch Med Sci, Dept Med & Bioregulatory Sci, Higashi Ku, Fukuoka 8128582, Japan

来源：

ENDOCRINE JOURNAL | 2000年 / 47卷 / 06期

关键词：

proinsulin; type; 2; diabetes; hyperglycemia; sulfonylurea;

D O I：

10.1507/endocrj.47.763

中图分类号：

R5 [内科学];

学科分类号：

1002 [临床医学]; 100201 [内科学];

摘要：

It is established that disproportionately elevated plasma proinsulin levels occur in patients with Type 2 diabetes. In the present study, multivariate analysis was performed to determine what factors contributed to the disproportionately elevated plasma proinsulin levels in Japanese patients with Type 2 diabetes (n = 276). Results from univariate analysis showed that both fasting proinsulin/C-peptide ratio and proinsulin/IRI ratio were approximately 2-fold higher in patients with Type 2 diabetes than those in healthy nondiabetic subjects (n = 45). In patients with Type 2 diabetes, both proinsulin/C-peptide ratio and proinsulin/IRI ratio were significantly positively correlated with fasting plasma glucose level (FPG) and HbA(1c). Neither proinsulin/C-peptide ratio nor proinsulin/IRI ratio was significantly correlated with BMI. Sulfonylurea-treated subjects had a significant elevation in both proinsulin/C-peptide ratio and proinsulin/IRI ratio compared with diet-treated subjects, whereas non-sulfonylurea hypoglycemic agent-treated subjects did not. Multivariate analysis confirmed that sulfonylurea treatment and FPG were significant determinants of both fasting proinsulin/C-peptide ratio (P = 0.006 and P = 0.030, respectively) and proinsulin/IRI ratio (P = 0.003 and P = 0.016, respectively) in patients with Type 2 diabetes. These results imply that disproportionate hyperproinsulinemia may reflect an excessive overwork of beta cells under chronic sulfonylurea treatment as well as hyperglycemia.

引用

页码：763 / 770

页数：8

共 26 条

[1]

EFFECT OF SULFONYLUREA THERAPY ON PLASMA-INSULIN, INTACT AND 32 33 SPLIT PROINSULIN IN SUBJECTS WITH TYPE-2 DIABETES-MELLITUS [J].