<原著>糖代謝異常を来す諸疾患における尿中C-peptide量

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Since C-peptide is produced in equimolar quantities with insulin, and excreted in urine at a level of 5% of 24 hr production, measurement of 24 hr urinary C-peptide excretion could be a simple indirect index of integrated 24 hr insulin production. Accordingly it can be used to assess integrated 24 hr insulin production and the β-cell function of various glucose intolerant states, including diabetes mellitus, obesity, Graves' disease, chronic hepatitis, liver cirrhosis and Cushing's syndrome. We measured 24 hr urinary C-peptide excretion with radioimmunoassay for 59 normal control subjects, 22 obese subjects, 92 patients with diabetes mellitus (type I 12,type II 80), 44 patients with Graves' disease, 26 patients with chronic hepatitis, 17 patients with liver cirrhosis and 5 patients with Cushing's syndrome. Twenty-four hours C-peptide excretion in urine was expressed as U-CPR/Cr, meaning the ratio of C-peptide to creatinine amounts in 24 hr urine to minimize the effects due to body mass and urinary volume. The value was given by μg/g・Cr. All comparison was performed between sex and age matched subjects. U-CPR/Cr was 46.9±4.3μg/g・Cr (mean±SE) for normal control subjects. In type I and type II diabetic patients on insulin treatment, U-CPR/Cr was 11.6±3.8 and 23.7±2.6μg/g・Cr respectively, being significantly decreased as compared with that of the control subjects (p<0.001 and p<0.001). In type II diabetic patients on sulfonylurea (SU) administration, U-CPR/Cr was 58.9±6.2μg/g・Cr, which was not significantly different from that of the controls. In type II diabetic patients on diet, U-CPR/Cr was 70.5±4.0μg/g・Cr, which was significantly increased as compared with that of the controls (p<0.001). In hyperthyroid patients with Graves' disease, U-CPR/Cr was 85.1±6.4μg/g・Cr, which was significantly increased as compared with that of the controls. In 15 eutyroid patients with Graves' disease, U-CPR/Cr was 51.6±4.9μg/g・Cr, which was not significantly different from that of the controls. In these two groups, there were positive correlations between U-CPR/Cr and T_3,and U-CPR/cr and T_4,(p<0.001 and p<0.001 respectively). In patients with chronic hepatitis and liver cirrhosis, U-CPR/Cr was 83.3±6.3 and 126±11.9μg/g・Cr respectively, being significantly increased as compared with that of the controls. In the study of these two groups, there was a negative correlation between U-CPR/Cr and cholinesterase (p<0.05). In obese subject, U-CPR/Cr was 105.6±4.3μg/g・Cr which was significantly increased as compared with that of controls (p<0.01). In control and obese subjects, highly significant correlation was obtained between U-CPR/Cr and weight indices (p<0.001). In patients with Cushing's syndrome, U-CPR/Cr was 123.3±37.7μg/g・Cr, which was significantly increased as compared with that of the controls (p<0.05). There was a positive correlation between U-CPR/Cr and urinary U-170HCS amounts in patients with Cushing's syndrome.
近畿大学の論文
1985-06-25

<原著>糖代謝異常を来す諸疾患における尿中C-peptide量

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