EVIDENCE FOR MARKED SENSITIVITY TO THE ANTI-LIPOLYTIC ACTION OF INSULIN IN OBESE MATURITY-ONSET DIABETICS
EVIDENCE FOR MARKED SENSITIVITY TO THE ANTI-LIPOLYTIC ACTION OF INSULIN IN OBESE MATURITY-ONSET DIABETICS
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DOI：
10.1016/0026-0495(79)90180-x
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发表时间：
1979-01-01
影响因子：
9.8
通讯作者：
BENNETT, PH
中科院分区：
文献类型：
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作者：
HOWARD, BV;SAVAGE, PJ;BENNETT, PH
对12例空腹胰岛素反应值仅为7±19μU/ml的肥胖型成年起病糖尿病PIMA印第安人和11例胰岛素反应值分别为2 5 2±34和73±18μU/ml的肥胖型非糖尿病PIMA印第安人和10例肥胖型非糖尿病高加索人群进行空腹葡萄糖耐量试验，观察血浆游离脂肪酸的变化。糖尿病患者的空腹游离脂肪酸水平较高，但与对照组相似(非糖尿病PIMA对照组为2 78±5 5比2 84±32，非糖尿病高血压组低于空腹2 6 2±43μeq/L)。血浆甘油水平的下降与游离脂肪酸水平的下降平行，这表明糖尿病患者的FFA变化可归因于抑制脂解而不是增加清除。在这些糖尿病患者的静脉葡萄糖耐量试验(IVGTT)中，胰岛素水平最初下降，而FFA没有下降。在第二组糖尿病患者(N=6)中，胰岛素在静脉葡萄糖耐量试验中的增量在空腹时平均为15±4.1FFA U/ml，其降幅再次与PIMA和高加索非糖尿病患者相当(空腹以下分别为214±53、234±37和183±51μeq/L)。这些发现表明，在被认为对胰岛素的降糖作用有抵抗力的个体中，对胰岛素的抗脂作用非常敏感。
Changes in plasma free fatty acids (FFA) observed during oral glucose tolerance tests in 12 obese maturity-onset diabetic Pima Indians with insulin response to oral glucose averaging only 7 ± 19 μU/ml above fasting were compared to those of 11 obese nondiabetic Pima Indians and 10 obese nondiabetic Caucasions who had mean insulin responses of 252 ± 34 and 73 ± 18 μU/ml, respectively. Fasting free fatty acid levels in the diabetics were higher, but they showed decreases similar to controls (278 ± 55 versus 284 ± 32 for nondiabetic Pima controls and 262 ± 43 μeq/liter below fasting for nondiabetic Caucasions). Plasma glycerol levels showed decreases parallel to those of free fatty acids, indicating that the FFA changes in the diabetics were attributable to inhibition of lipolysis rather than to increased removal. During intravenous glucose tolerance tests (IVGTT) in these diabetics, insulin levels decreased initially and there was no decline in FFA. In a second group of less severe diabetics (N= 6), whose increments in insulin during intravenous glucose tolerance tests averaged 15 ± 4.1 μU/ml above fasting, FFA decreases were again comparable to Pima and Caucasion nondiabetics (214 ± 53, 234 ± 37, and 183 ± 51 μeq/liter below fasting, respectively). These findings demonstrate marked sensitivity to the antilipolytic effects of insulin in individuals considered to be resistant to its glucose-lowering action.