Abstract
Objective To expore the functional changes of islet α- and β-cells in early-onset type 2 diabetes mellitus. Method Forty patients with early-onset type 2 diabetes mellitus (EOD group), 40 patients with late-onset type 2 diabetes mellitus (LOD group) and 30 normal controls (NC group) were recruited in this study and received oral glucose tolerance test, insulin and glucagon release tests. Blood glucose, insulin and glucagon levels were compared before and after glucose loading. Analysis of variance was used for comparison between groups, and t test or Mann-Whitney U test were used for pairwise comparison. Results There were no significant differences in blood glucose levels between EOD and LOD group at each time point (t=-1.101-0.007, both P>0.05); Fasting insulin and fasting glucagon in EOD group were significantly higher than those in LOD and control groups (U=140.000-218.000, both P<0.01); HOMA-IR in EOD group were higher than those in LOD and NC group (t=4.980, 2.094, both P<0.05), ISIMatsuda in EOD group were lower than those in LOD and NC group (t=-4.315, -2.146, both P<0.05), HOMA-β and ΔI30/ΔG30 in EOD group were higher than those in LOD group but lower than those in NC group (t=2.140-9.166, both P<0.05), AUCIns in EOD group were higher than those in LOD group (t=-1.527, 2.319, P<0.05), AUCGcg and Gcg/Glu in fasting and 1, 2 h after glucose loading in EOD group were higher than those in LOD group (2 h Gcg/Glu in EOD group was 1.4±0.7, and was 1.0±0.8 in LOD, t=2.113-3.354, both P<0.05). Conclusions β-cell function in EOD patients is better than that in LOD patients. However, compared with LOD patients, the insulin resistance and the islet α cell dysfunction are higher in EOD patients, including high levels of fasting glucagon, lower inhibition effect of blood glucose on glucagon, which may be one of the reasons for the early-onset type 2 diabetes mellitus. Key words: Diabetes mellitus, type 2; Early-onset; Islet α-cell; Islet β-cell
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