Impact of 9 days of bed rest on hepatic and peripheral insulin action, insulin secretion, and whole-body lipolysis in healthy young male offspring of patients with type 2 diabetes.
Impact of 9 days of bed rest on hepatic and peripheral insulin action, insulin secretion, and whole-body lipolysis in healthy young male offspring of patients with type 2 diabetes.
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作者：
Alibegovic AC;Højbjerre L;Sonne MP;van Hall G;Stallknecht B;Dela F;Vaag A
本研究的目的是调查9天卧床休息对一级亲属（FDR）和匹配对照（CON）受试者的胰岛素分泌、胰岛素作用以及全身葡萄糖和脂肪代谢的影响。共有13名FDR受试者和20名CON受试者参加了研究。所有的研究之前和之后的9天卧床休息使用钳夹技术结合间接量热法之前，静脉葡萄糖耐量试验。葡萄糖和甘油周转率进行了研究，使用稳定同位素动力学。卧床休息导致两组的全身胰岛素敏感性显著降低。FDR受试者在卧床休息前肝脏胰岛素抵抗升高，卧床休息后FDR受试者肝脏胰岛素抵抗显著增加（P < 0.01），而CON受试者肝脏胰岛素抵抗无显著增加（P = NS）。FDR和CON受试者在卧床休息期间全身脂解率均下降，两组之间无显著差异。卧床引起的胰岛素抵抗完全由两组非氧化性糖代谢受损引起（总体P < 0.001）。在胰岛素抵抗FDR和健康CON受试者中，全身胰岛素作用随着9天的卧床休息而恶化，朝着相似程度的全身胰岛素抵抗会聚。FDR受试者表现出肝胰岛素抵抗（HIR），与CON受试者相反，其响应于身体活动而恶化。FDR受试者表现出减少的胰岛素分泌，当看到与他们的HIR程度，但不是外周胰岛素抵抗。
The aim of this study was to investigate the impact of 9 days of bed rest on insulin secretion, insulin action, and whole-body glucose and fat metabolism in first-degree relative (FDR) and matched control (CON) subjects. A total of 13 FDR and 20 CON subjects participated in the study. All were studied before and after 9 days of bed rest using the clamp technique combined with indirect calorimetry preceded by an intravenous glucose tolerance test. Glucose and glycerol turnover rates were studied using stable isotope kinetics. Bed rest caused a significant decrease in whole-body insulin sensitivity in both groups. Hepatic insulin resistance was elevated in FDR subjects prior to bed rest and was significantly augmented by bed rest in FDR (P < 0.01) but not in CON (P = NS) subjects. The rate of whole-body lipolysis decreased during bed rest in both FDR and CON subjects, with no significant differences between the groups. Insulin resistance induced by bed rest was fully accounted for by the impairment of nonoxidative glucose metabolism in both groups (overall P < 0.001). Whole-body insulin action in both insulin-resistant FDR and healthy CON subjects deteriorates with 9 days of bed rest, converging toward similar degrees of whole-body insulin resistance. FDR subjects exhibit hepatic insulin resistance (HIR), which, in contrast to CON subjects, deteriorates in response to physical inactivity. FDR subjects exhibit reduced insulin secretion when seen in relation to their degree of HIR but not peripheral insulin resistance.
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