The value of arginine stimulation test in evaluating the first-phase insulin secretion and its guiding role for the treatment of type 2 diabetes mellitus
10.12025/j.issn.1008-6358.2017.20170602
- VernacularTitle:精氨酸刺激试验评估胰岛β细胞1相分泌功能的价值及对2型糖尿病治疗的指导作用
- Author:
Xiao-Peng ZHU
1
;
Hong-Mei YAN
;
Xin-Xia CHANG
;
Ming-Feng XIA
;
Liu WANG
;
Hua BIAN
;
Xin GAO
Author Information
1. 复旦大学附属中山医院内分泌科
- Keywords:
arginine stimulation test;
type 2 diabetes;
islet β cell function
- From:
Chinese Journal of Clinical Medicine
2017;24(4):548-553
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of arginine stimulation test in evaluating the first-phase insulin secretion and its guiding role for the treatment of type 2 diabetes mellitus.Methods:Totally 80 cases with newly diagnosed type 2 diabetes mellitus(NT2DM),male/female,54/26),162 type 2 diabetes subjects with effective treatment by lifestyle intervention or oral hypoglycemic drugs therapy(LIODT),male/female,79/83),160 subjects with insulin therapy(IT),,male/female,63/97 and 40 subjects with normal glucose level(NC,male/female,5/35)were admitted in the study in Department of Endocrinology,and the Physical Examination Center of Zhongshan Hospital,Fudan University.Arginine stimulation test was performed to assess the first-phase insulin secretion.Fasting and 2,4,6 min glucose(G),insulin(I)and c-peptide(CP)after arginine stimulating were tested.Objective:The Δ I,Δ I/G,Δ CP/G in arginine stimulation test were decreased significantly in the patients with NT2DM,LIODT and IT groups than those in the NC group(P<0.01).Among different groups of type 2 diabetes,Δ I,Δ CP,Δ I/G,ΔCP/G were decreased significantly in the IT group than the other two groups(P<0.01).The normal cut-off point of AIR was Δ I≥23.09 mU/L.Δ I,Δ I/G,Δ CP/G negatively correlated with fasting plasma glucose(FPG)and HbA1c,and Δ I,Δ CP,Δ I/G,Δ CP/G were negatively correlated with daily dose and numbers of oral diabetic medications after adjustment for gender,age,BMI.In the known type 2 diabetes groups(including LIODT and IT group),the optimal cut-off values from ROC curve for initiating insulin therapy were ΔI≤12.23 mU/L,and ΔCP≤0.97 ng/mL(P<0.01).Conclusions:Arginine stimulation test can effectively assess the first-phase insulin secretion.In type 2 diabetes,ΔI≤12.23 mU/L or ΔCP≤0.97 ng/mL suggest severely lost of first-phase insulin secretion,and need insulin therapy.
