The Relationships Of Concentration Of True Insulin And Proinsulin With Macroangiopathy In Type 2 Diabetes Milltus: Preliminary Study

Objective:To determine serum true insulin (TI) and proinsulin (PI),immunoreactive insulin (IRI) concentration in subjects A.B.C.group; to explore the relationships of them to other macroangiopathy risk factors.Method:All the subjects included Group A (n=25) healthy subjects.Group B (n=40) type 2 diabetes millitus with macroangiopathy.Group C (n=30) type 2 diabetes without macroangiopathy .The three group were age BMI WHR matched.Highly sepcific RIA for TI and PI and standard RIA for IRI were used. The fasting plasmaglucose, serum IRI, TIjPIJipidSjBUNjUAjCrjHbA^ 3^ 2h postprandial serumTI,PI,IRI were determined in each individials.The insulin resistance index (Homa-IR) and pancreatic 0 cell function index(Homa- ) and insulin sensitivity index (ISI) were calculated in all subjects.Results :1.The fasting and 2h postprandial serum IRI levels in B,C gtoup was significantly higher than that in A group (p<0.05) The IRI levels in B group was higher than that in C group.The changing tendence was B>OA(p<0.05).2.The fasting and 2h postprandial TI levels in B,Cgroup was also significantly higher than that in A group (p<0.05).It showed no significant difference between B and C group (p>0.05).3.The fasting and 2h postprandial PI levels in B,C group was significantly higher than that in A group (PO.05) and it ligher in B group than that in C group.The changing tendence was B>OA(p<0.05).4.The pancreatic 3 cell function index of IRI (Homa- IRI) in A,B,Cgroup have no significant difference (p>0.05).The pancreatic P cell function index of TI (Homa-P T,) in B,C group were lower than that in A group (p<0.05).The Homa- P T, in B,C group showed no significant difference (p>0.05).5.The insulin resistance index(Homa-IR) and the insulin sensitivity index(ISI) of IRI and TI: blth show that B,C group were higher than C group (p<0.05) and B group had the highest Homa-IRIR],Homa IRj^the lowest ISIIRi ISIj,.6.The correlation of IRI with TI: There wsa a significant correlation between TI and IRI (p<0.05) in the all group.The "r"was the highest in A group.7.The correlation of TI,PI with other macroangiopathy risk facrors: Controlling age,BMI.WHR,TI,PI were postively correlated with TG,TC,LDL,UA and negatively correlated with HDL(p<0.05),not correlated with HbA,c, plasma glucose.Multiple stepwise regression analysis showed that TI PI were independent risk factors to macroangiopathy.Conclusion:1.There was important clinical significance to determine the serum TI and PI in subject with type 2 diabetes milltus especially for evaluating p -cell function.2. Serum TI,PI levels in type 2 diabetes millitus patients with or without macroangiopathy were higher and it was the highest in type 2 diabetes milltus with macroangiopathy.3.Pancreatic P-cell function index (Homa-& ) of TI was better than that of IRIAThpe 2 diabetes milltus wity or without macroangiopathy have high Homa-IR and low Homa-ISI.5.There was a independent correlation between TI PI and dyslipidemia ,hypertention .