«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

26卷

期数:

2020年03期

页码:

218-221,229

栏目:

临床医学

出版日期:

2020-06-10

文章信息/Info

Title:

Comparative analysis of islet function indices in insulinoma and insulin autoimmune syndrome

文章编号:

1006-8147(2020)03-0218-04

作者:

乔丽丽¹; 2; 何庆¹; 贾彦春³; 陈荷叶¹; 贾红蔚¹

（1.天津医科大学总医院内分泌代谢科，天津 300052；2.河北大学附属医院内分泌科，保定071000；3.天津市南开区三潭医院内科，天津 300193）

Author(s):

QIAO Li-li¹; 2;  HE Qing¹;  JIA Yan-chun³;  CHEN He-ye¹;  JIA Hong-wei¹

（1.Department of Endocrinology and Metabolism， General Hospital， Tianjin Medical University， Tianjin 300052， China； 2. Department of Endocrinology，Affiliated Hospital of Hebei University，Baoding 071000， China； 3.Department of Medicine， Santan Hospital, Nankai District, Tianjin 300193, China）

关键词:

胰岛素瘤; 胰岛素自身免疫综合征; 胰岛功能; 胰岛素; C肽

Keywords:

insulinoma; insulin autoimmune syndrome; islet function; insulin; C-peptide

分类号:

R587.3

DOI:

-

文献标志码:

A

摘要:

目的：比较分析不同胰岛功能指标在胰岛素瘤和胰岛素自身免疫综合征（IAS）中的诊断价值。方法：回顾性分析我院2005年1月-2019年3月明确诊断的胰岛素瘤和IAS病例，比较分析胰岛素（INS）、胰岛素释放指数（IRI）、胰岛素释放修正指数（修正IRI）、C肽、C肽释放指数（CPI）、C肽释放修正指数（修正CPI）、胰岛素/C肽在两组诊断价值以及低血糖发作时胰岛素与C肽相关性研究。结果：胰岛素瘤组24例，IAS组9例，各指标在胰岛素瘤组和IAS组中均有差异。IAS组INS、IRI、修正IRI、C肽、CPI、修正CPI、胰岛素/C肽都高于胰岛素瘤组（均P<0.01）。低血糖发作时，IAS组INS与C肽之间相关性不显著，在胰岛素瘤组中相关性为0.695（P<0.01）。结论：利用各胰岛功能指标在胰岛素瘤和IAS中的差异表达，有助于提高胰岛素瘤和IAS在临床中的鉴别诊断。

Abstract:

Objective: To evaluate the diagnostic value of different islet function indices in insulinoma and insulin autoimmune syndrome（IAS）. Methods: The clinical date of patients with insulinoma and insulin autoimmune syndrome were retrospectively analyzed from January 2005 to March 2019. The diagnostic value of insulin (INS), insulin release index (IRI), amended IRI, C-peptide, CPI, amended CPI, insulin/C-peptide in insulinoma and IAS were compared and the relationship between insulin and C-peptide during hypoglycemia were compared. Results: There were 24 cases in insulinoma group and 9 cases in IAS group，each index had significant differences between the two groups. The data of two groups showed that the expression level of insulin, insulin release index, amended IRI, C-peptide, CPI, amended CPI, insulin/C-peptide of the IAS group were higher than those in the insulinoma group(all P<0.05). There was no significant correlation between INS and C-peptide in IAS group when hypoglycemia，and the correlation in insulinoma group was 0.695, P<0.01. Conclusion: The differential expression of various islet function indexes in insulinoma and IAS is helpful to improve the differential diagnosis of insulinoma and IAS.

参考文献/References:

[1] 陈灏珠,钟南山,陆再英，等. 内科学[M]. 第9版. 北京:人民卫生出版社, 2018:749-753
[2] 夏维波,顾锋,吴韬,等.胰岛素自身免疫综合征三例并文献复习[J].中华内科杂志, 2006,45(1):61
[3] Cryer P E, Axelrod L, Grossman A B, et al. Evaluation and management of adult hypoglycemic disorders: an endocrine society clinical practice guideline[J]. J Clin Endocrinol Metab, 2009, 94(3):709
[4] Ahn C H, KimL K, Lee J E, et al. Clinical implications of various criteria for the biochemical diagnosis of insulinoma[J]. Endocrinol Metab, 2014, 29(4):498
[5] Maggio I, Mollica V, Brighi N, et al. The functioning side of the pancreas: a review on insulinomas[J]. J Endocrinol Invest, 2020, 43(2):139
[6] Ismail A A. The insulin autoimmune syndrome(IAS) as a cause of hypoglycaemia: an update on the pathophysiology, biochemical investigations and diagnosis[J]. Clin Chem Lab Med, 2016, 54(11): 1715
[7] Sharwood E F, Hughes I P, Pretorius C J, et al. Therapeutic plasma exchange normalizes insulin-mediated response in a child with type 1 diabetes and insulin autoimmune syndrome[J]. Pediatr Diabetes, 2018,19(1):171
[8] Church D, Cardoso L, Bradbury S, et al. Diagnosis of insulin autoimmune syndrome using polyethylene glycol precipitation and gel filtration chromatography with ex vivo insulin exchange[J]. Clin Endocrinol (Oxf), 2017, 86(3):347
[9] Reis M Z R, Fernandes V O, Fontenele E G P, et al. Insulin autoimmune syndrome in an occidental woman: a case report and literature review[J]. Arch Endocrinol Metab, 2018, 62(5):566
[10] Saxon D R, Mcdermott M T, Michels A W. Novel management of insulin autoimmune syndrome with rituximab and continuous glucose monitoring [J]. J Clin Endocrinol Metab, 2016, 101(5):1931
[11] Moffa S, Improta I, Rocchetti S, et al. Potential cause-effect relationship between insulin autoimmune syndrome and alpha lipoic acid: Two case reports[J]. Nutrition, 2019, 57(57):1
[12] Cappellani D, Sardella C, Campopiano M C, et al. Spontaneously remitting insulin autoimmune syndrome in a patient taking alpha-lipoic acid[J].Endocrinol Diabetes Metab Case Rep, 2018, 2018: 18
[13] Kusano Y. Insulin autoimmune syndrome possibly caused by coenzyme Q10[J]. J Rural Med, 2019,14(1):132
[14] Censi S, Mian C, Betterle C. Insulin autoimmune syndrome:from diagnosis to clinical management[J]. Ann Transl Med, 2018, 6(17):335
[15] WooC Y, Jeong J Y, Jang J E, et al. Clinical features and causes of endogenous hyperinsulinemic hypoglycemia in Korea[J]. Diabetes Metab J, 2015, 39(2):126
[16] Redmon J B, Nuttall F Q. Autoimmune hypoglycemia[J]. Endocrinol Metab Clin North Am, 1999, 28(3):603
[17] Lupsa B C, Chong A Y, Cochran E K, et al. Autoimmune forms of hypoglycemia[J]. Medicine, 2009, 88(3):141
[18] 杨望荣,罗佐杰,梁敏,等. 胰岛素类似物致2型糖尿病患者免疫性低血糖二例并文献复习[J]. 中国糖尿病杂志, 2013, 5(5):1674
[19] 张俊清，郭晓蕙. 胰岛素瘤10例临床特点分析[J]. 中国实用内科杂志， 2006, 26(22):1805
[20] 冯留顺,李旭辉,李捷,等. 胰岛素瘤的诊断和治疗:附120例报告[J].中国普通外科杂志, 2007, 16(5):480
[21] Church D, Cardoso L, Kay R G, et al. Assessment and management of anti-insulin autoantibodies in varying presentations of insulin autoimmune syndrome[J]. J Clin Endocrinol Metab, 2018, 103(10):3845
[22] 金丽霞,肖建中. 胰岛素自身免疫综合征研究进展[J]. 中华实用诊断与治疗杂志, 2018, 32(4):399
[23] 韩俊峰，张锋，包玉倩，等. 糖代谢相关指标对诊断胰岛素瘤的临床价值[J]. 中华医学杂志， 2010, 90(16):1093

相似文献/References:

备注/Memo

备注/Memo:

基金项目 河北省重点研发计划项目（182777105D）
作者简介 乔丽丽（1984-）,女,主治医师,硕士在读,研究方向：内分泌与代谢性疾病；通信作者：何庆，E-mail：935264994@ qq.com。

常用功能

更新日期/Last Update: 2020-06-13