ASSOCIATION OF ELEVATED FASTING C-PEPTIDE LEVEL AND INCREASED INTRA-ABDOMINAL FAT DISTRIBUTION WITH DEVELOPMENT OF NIDDM IN JAPANESE-AMERICAN MEN
ASSOCIATION OF ELEVATED FASTING C-PEPTIDE LEVEL AND INCREASED INTRA-ABDOMINAL FAT DISTRIBUTION WITH DEVELOPMENT OF NIDDM IN JAPANESE-AMERICAN MEN
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DOI：
10.2337/diabetes.39.1.104
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发表时间：
1990-01-01
期刊：
影响因子：
7.7
通讯作者：
FUJIMOTO, WY
中科院分区：
文献类型：
--
作者：
BERGSTROM, RW;NEWELLMORRIS, LL;FUJIMOTO, WY
华盛顿金县的日裔美国人是非胰岛素依赖型糖尿病（NIDDM）的高发人群。作为一项社区研究的一部分，我们重新检查了146名最初被归类为非糖尿病的第二代日裔美国男性。在平均30个月的随访期间，15名男性发展为NIDDM， 131名未患糖尿病。在初次访问时，将15名糖尿病男性与131名非糖尿病男性区分出来的变量是年龄较大，口服75克葡萄糖后2小时较高的血清葡萄糖水平，较高的空腹血浆c肽水平，以及通过计算机断层扫描确定的腹部内横断面脂肪面积增加。年龄和较高的2小时血糖水平都是与NIDDM发展相关的变量，但较高的空腹c肽水平和较大的腹内脂肪面积与随后的NIDDM发展的关联是新的观察结果。调整空腹血糖后，空腹c肽水平持续升高。升高的c肽水平代表了胰岛素的高分泌，并被解释为反映了在NIDDM发生之前对潜在胰岛素抵抗状态的代偿反应。空腹c肽水平与腹内脂肪面积相关，提示腹内脂肪面积可能与胰岛素抵抗有关。因此，在患有NIDDM的个体中，胰岛素抵抗、胰岛素分泌增加和腹内脂肪增加在糖尿病糖耐量被证实之前就已经存在。
The Japanese-American population of King County, Washington, is known to have a high prevalence of non-insulin-dependent diabetes mellitus (NIDDM). As part of a community-based study, we reexamined 146 second-generation Japanese-American men who had been initially classified as nondiabetic. At a mean follow-up period of 30 mo, 15 men had developed NIDDM, and 131 remained nondiabetic. The variables measured at the initial visit that distinguished the 15 diabetic men from the 131 nondiabetic men were older age, higher serum glucose level at 2 h after 75 g oral glucose, higher fasting plasma C-peptide level, and increased cross-sectional intra-abdominal fat area as determined by computed tomography. Both older age and higher 2-h glucose levels are variables that have been associated with the development of NIDDM, but the association of higher fasting C-peptide level and greater intra-abdominal fat area with subsequent development of NIDDM were new observations. The elevated fasting C-peptide level persisted after adjustment for fasting serum glucose. The elevated C-peptide level represents hypersecretion of insulin and was interpreted to reflect a compensatory response to an underlying insulin resistant state that antedates the development of NIDDM. The fasting C-peptide level was correlated with the intra-abdominal fat area, suggesting that the intra-abdominal fat area may be associated with insulin resistance. Thus, in individuals who develop NIDDM, insulin resistance, increased insulin secretion, and increased intra-abdominal fat are present before diabetic glucose tolerance can be demonstrated.