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  • Title: [The clinical significance of true insulin and proinsulin levels in subjects with different glucose tolerance].
    Author: Yang J, Li M, Wu C.
    Journal: Zhonghua Nei Ke Za Zhi; 2000 Dec; 39(12):811-3. PubMed ID: 11798541.
    Abstract:
    OBJECTIVE: To examine the levels of serum true insulin (TI) and proinsulin (PI) in individuals with different glucose tolerance and to assess its clinical significance. METHODS: The levels of true insulin and proinsulin during oral glucose tolerance test (OGTT) were determined with specific BA-ELISA in 135 normal glucose tolerance (NGT) and 86 impaired glucose tolerance (IGT) subjects as well as 101 type II diabetes mellitus (DM) patients. RESULTS: The fasting TI levels showed no significant difference (P > 0.05) among the groups of NGT, IGT and type II DM, but the immunoreactive insulin (IRI) concentration increased significantly in type II DM patients as compared with that in NGT (P < 0.01). Both of the fasting PI levels and the ratio of PI/(PI + TI) were significantly higher in type II DM patients as compared with those in NGT or IGT. The area under the curve of TI (AUC(TI)) was significantly higher (P < 0.05) in IGT than NGT and type II DM. Obese subjects had higher TI levels (P < 0.01) and lower insulin sensitivity (P < 0.05) than those in non-obese, while the ratio of PI/(PI + TI) and AUC(TI) was not significantly different statistically (P > 0.05) between the obese and non-obese subjects. CONCLUSION: Type II DM patients present hyperproinsulinemia rather than hyperinsulinemia and have higher ratio of PI/(PI + TI) as compared with NGT and IGT subjects. Higher TI level and significant insulin resistance were observed in obese subjects, but there is no difference of the PI/(PI + TI) ratio. The fasting PI level and PI/(PI + TI) ratio tend to be the indexes of beta-cell dysfunction.
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