Chronic Sulfonylurea Treatment and Hyperglycemia Aggravate Disproportionately Elevated Plasma Proinsulin Levels in Patients with Type 2 Diabetes

Endocrine Journal

TAKASHI ETOH¹  FUMIO UMEDA¹  KATSUMI NODA¹  TSUYOSHI AOKI¹  TOYOSHI INOGUCHI¹  HIROYASU YOSHIKAWA¹  MAKOTO KUNISAKI¹  HIDEHIRO ISHII¹  TOSHIHIKO HASHIMOTO¹  MAIKO KAKIMOTO¹  HM-YAN YU¹  MINAKO IMAMURA¹  YASUHIRO SAKO¹  HAJIME NAWATA¹ 

[1] Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University

关键词: Proinsulin;    Type 2 diabetes;    Hyperglycemia;    Sulfonylurea;   

DOI  :  10.1507/endocrj.47.763

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(25)Cited-By(16)It is established that disproportionately elevated plasma proinsulin levels occur in patients with Type 2 diabetes. In the present study, multivariate analysis was performed to determine what factors contributed to the disproportionately elevated plasma proinsulin levels in Japanese patients with Type 2 diabetes (n=276). Results from univariate analysis showed that both fasting proinsulin/C-peptide ratio and proinsulin/IRI ratio were approximately 2-fold higher in patients with Type 2 diabetes than those in healthy nondiabetic subjects (n=45). In patients with Type 2 diabetes, both proinsulin/C-peptide ratio and proinsulin/IRI ratio were significantly positively correlated with fasting plasma glucose level (FPG) and HbA1c. Neither proinsulin/C-peptide ratio nor proinsulin/IRI ratio was significantly correlated with BMI. Sulfonylurea-treated subjects had a significant elevation in both proinsulin/C-peptide ratio and proinsulin/IRI ratio compared with diet-treated subjects, whereas nonsulfonylurea hypoglycemic agent-treated subjects did not. Multivariate analysis confirmed that sulfonylurea treatment and FPG were significant determinants of both fasting proinsulin/C-peptide ratio (P=0.006 and P=0.030, respectively) and proinsulin/IRI ratio (P=0.003 and P=0.016, respectively) in patients with Type 2 diabetes. These results imply that disproportionate hyperproinsulinemia may reflect an excessive overwork of β cells under chronic sulfonylurea treatment as well as hyperglycemia.

【 授权许可】

Unknown