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당뇨병 환자에 있어서 혈중 Insulin 및 C-Peptide 동태에 대하여

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dc.description.abstract[한글] 당뇨병은 체내 insulin의 절대적 또는 상대적 결핍에 기인하는 질환이라고 정의할 수 있다. 따라서 혈중 insulin의 측정은 당뇨병의 상태를 파악하는데 중요역할을 한다. 과거에는 insulin 측정에 생물학적 방법을 주로 사용하였으나 1960년 Berson과 Yalow가 방사 면역측정법을 처음 고안한 후 현재 insulin은 물론 connecting peptide (C-peptide)도 간단히 측정할 수 있게 되었다. 공복혈청의 insulin 및 C-peptide 치만으로 당뇨병을 진단하기에는 불충분하며 당부하검사와 동시에 insulin과 C-peptide 변동에 대해 실험한 바 그 결과를 보고 하고자 한다. 본 실험에서 정상대조군 15명, 당뇨병 환자 25명을 대상으로 하였고, 공복혈당치가 200㎎/㎗ 이하되는 환자를 경증군, 이 이상치를 나타낸 환자를 중증군으로 분류하여 관할한 결과는 다음과 같다. 1. 정상인군의 공복시 혈청 insulin C-peptidecl는 각각 21.6±5.6μU/㎕ 및 1.79±0.19 ng/㎖, 경증당뇨병군은 30.6±2.0 μU/㎕ 및 2.36±0.16 ng/㎖를, 중증군은 9.7±0.7 μU/㎕ 및 1.34±0.13 ng/㎖를 나타내어 졍증당뇨병군 공복시 insulin과 C-peptide는 상승하고 중증군은 정상대조군치 보다 낮았다. 2. 경구 당부하후 정상인군의 혈당치는 30분에 최고치를 insulin은 60분에 최고치를, C-peptide 치는 insulin과 비슷하거나 좀 늦게 최고치를 나타내고 그후 낮아졌다. 3. 정상군에서 당부하후 insulin 과 C-peptide의 평균 최고치는 부하전치에 비해 각각 3.4배, 3.7배 상승했다. 4. 경증군에서 insulin의 최고치는 정상군치와 거의 비슷하나 180분까지도 높은 치를 나타냈고, C-peptide의 최고치는 정상군보다는 약간 낮았으나 insulin과 같은 양상을 나타냈다. 5. 중증군에서는 insulin과 C-peptide 모두 경증군보다 훨씬 낮은치를 나타냈고 또한 지연반응을 보였다. 특히 중증 약년성 당뇨군에서 당부하검사 동안 C-peptidecl는 1.0 ng/㎖인 낮은치를 보였다. [영문] Several methods have been applied for determination of insulin in human serum. The bioassay methods most commonly attempted utilize the insulin sensitivity for glucose uptake by isolated rat diaphragm, or the oxidation of glucose by the isolated rat epididymal fatpad. More recently radioimmunoassays have been widely usedm which depend on competetion between serum insulin and I**125-insulin, C-peptide and I**125-C-peptide for a limited amount of guinea-pig antiserum antibody. In 1960, however Berson and Yalow devised a radioimmunoassay which was more sensitive and simpler in procedure than the conventional methods. In recent years, several different radioommunoassays have been decised for human C-peptide and proinsulin. The significance of the development lies in the potential for measuring beta cell secretary function in diabetics. I studied recently for determination of serum insulin and C-peptide in normal and diabetic subjects before and after oral glucose loadings. Fifteen subjects served as normal controls. All of them had normal glucose tolerance by the oral GTT. Twenty-five patients with diabetes mellitus were classified according to fasting blood sugar levels as either mile diabetic group with that below 200 mg/dl or severe diabetic group with that above 201 mg/dl. Five chemical diabetics were included in mild diabetic group. Mean fasting level of serum insulin and C-peptide in normal subjects were 21.6±5.6μU/㎕ and 1.79±0.19 ng/㎖, respectively : in mild diabetic group 30.6±1.9 μU/㎕ and 2.36±0.25 ng/㎖, in severe group 9.7±0.7 μU/㎕ and 1.34±0.13 ng/㎖, respectively. These results indicated that fasting serum insulin and C-peptide levels were somewhat elevated in mild diabetic group but lowered in serve and juvenile diabetic groups. Blood sugar, serum insulin and C-peptide were also determined in serum obtained from normal and diabetics in fasting state, and 30, 60, 120 and 180 minutes following 100 gm glucose per oral. In normal subjects, serum insulin and C-peptide rose briskly, reaching a peak within thirty to sixty minutes in insulin, but C-peptide level tends to reach the peak a little later than insulin, and declined. The mean peak level of serum insulin and C-peptide were about 3.4 and 3.7 times than the fasting levels, respectively. In mild diabetic groups, the mean peak level of serum insulin was as the same as the normal control but delayed with nigner level until 180 minutes, but the peak level of C-peptide was developed with low and delayed response than in normal. The mean peak level of serum insulin and C-peptide weere more lowered and delayed in severe diabetic group than in normal and mild diabetic groups.-
dc.publisher연세대학교 대학원-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.title당뇨병 환자에 있어서 혈중 Insulin 및 C-Peptide 동태에 대하여-
dc.title.alternativeStudies on serum insulin and C-peptide in diabetics by the radioimmunoassay-
dc.contributor.alternativeNameLee, Si Won-
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1. College of Medicine (의과대학) > Others (기타) > 2. Thesis


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