Research on mechanism of hypoglycemia in Patients with Severe Chronic Hepatitis B.
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摘要: 目的研究慢重肝患者的空腹IGF-1、胰岛素、C肽、皮质醇水平及能量代谢的营养底物的氧化率,来探讨慢重肝患者发生低血糖的机制。方法选取20例慢重肝低血糖患者,并以20例慢性肝炎患者作为对照组,应用R IA法测定IGF-1值、胰岛素、C肽、皮质醇;应用代谢车测定其糖、脂肪、蛋白质三种营养底物氧化率。结果慢重肝组与对照组分别比较血清IGF-1(11.9±2.6)ng/ml vs(159.8±35.7)ng/ml(P=0.000);血清胰岛素(19.2±10.9)μIU/ml vs(10.6±7.3)μIU/ml(P=0.034);慢重肝组糖氧化率、脂肪氧化率分别与对照组比:38.5%vs 56.9%(P=0.020)、38.8%vs 20.1%(P=0.028);慢重肝组糖氧化率与空腹血糖呈正相关(r=0.45,P<0.05)。结论慢重肝患者低血糖的发生与血清IGF-1值、胰岛素水平密切相关,且空腹血糖与糖的氧化利用率正相关。
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关键词:
- 慢性重型乙型肝炎 /
- 胰岛素样生长因子-1 /
- 能量代谢
Abstract: Objective To investigate mechanism of hypoglycemia in patients with severe chronic hepatitis B, we detected the level of fasting blood serum C-peptide, the level of fasting serum cortisol and the substrate oxidation of the resting energy metabolism in patients with severe chronic hepatitis B.Methods We detected the level of fasting blood serum insulin-like growth factor (IGF-1) , the level of fasting serum insulin, the level of fasting serum C-peptide, the level of fasting serum cortisol in 20 patients with severe chronic hepatitis B and 20 patients with chronic hepatitis B by RIA;resting energy metabolistic indexes (Oxindation of carbohydrate, fat and protein) in patients with severe chronic hepatitis B and patients with chronic hepatitis B by indirect calorimetry.Results The level of fasting blood serum IGF-1 in patients with Severe Chronic Hepatitis B (11.9±2.6) ng/ml were all significantly lower than those in patients with chronic hepatitis B (159.8±35.7) ng/ml (P=0.000) ;the level of serum insulin with severe chronic hepatitis B (19.2±10.9) μ IU/ml was significantly higher than those in the patients with chronic hepatitis B (10.6±7.3) μIU/ml (P=0.034) ;The oxidation of carbohydrate in patients with severe chronic hepatitis B was 38.5%, which was significantly lower than that in patients with chronic hepatitis B 56.9% (P=0.020) ;The oxidation of fat in patients with severe chronic hepatitis B was 38.8%, which was significantly higher than that in patients with chronic hepatitis B 20.1% (P=0.028) .The oxidation of carbohydrate in patients with severe chronic hepatitis B had positive correlation with the level of the fasting blood glucose (r=0.45 P<0.05) .Conclusion The occurrence of hypoglycemia has closely correlation with the level of IGF-1 and insulin, while the level of the fasting blood glucose also has positive correlation with the oxidation of carbohydrate in patients with severe chronic hepatitis B. -
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