IMPACT OF OBESITY ON INSULIN ACTION IN NIDDM
IMPACT OF OBESITY ON INSULIN ACTION IN NIDDM
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DOI：
10.2337/diabetes.42.3.405
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发表时间：
1993-03-01
期刊：
影响因子：
7.7
通讯作者：
CARLSON, MG
中科院分区：
文献类型：
--
作者：
CAMPBELL, PJ;CARLSON, MG
虽然肥胖和NIDDM之间存在着很强的临床相关性，但以前的研究未能证实肥胖程度和NIDDM的胰岛素抵抗之间存在显著的关系。采用葡萄糖钳夹技术，观察了25例NIDDM患者在胰岛素输注时间分别为0.4、1.0和10Muu/kg时，肥胖对胰岛素介导的糖代谢的影响。比较了14名糖尿病患者和19名性别、年龄和体重分布相似的非糖尿病对照组的血糖处理率和HGP。我们发现体重指数与维持正常血糖所需的葡萄糖输注率呈负相关(r=-0.001.6 3，P<0.0 5，r=-0.5 7，P<0.0 1，r=-0.36，P=0.0 8)。胰岛素用量为1.0mU/kg时，血糖水平与体重指数呈正相关(r=-0.57，P<；0.05)，胰岛素用量为0.4mU/kg时，血糖生成量与体重指数呈正相关(r=0.69，P<；0.01)。我们的结论是，肥胖降低了NIDDM患者肝脏和外周组织的胰岛素敏感性。肥胖加重了NIDDM患者的胰岛素抵抗，表明减肥是治疗肥胖NIDDM患者的有效方法。
Although a strong clinical association exists between obesity and NIDDM, previous studies have failed to confirm a significant relationship between the degree of obesity and the insulin resistance of NIDDM. We examined the impact of obesity on insulin-mediated glucose metabolism in 25 patients with NIDDM, whose BMI ranged from 20.8 to 36.9 kg/m2, during insulin infusions of 0.4, 1.0, and 10 muU/kg min using the glucose clamp technique. Rates of glucose disposal and HGP were compared in 14 of the diabetic patients with 19 nondiabetic control subjects of similar sex, age, and weight distribution. We found an inverse correlation between BMI and the glucose infusion rate necessary to maintain euglycemia during the first two of three insulin infusions (r = -0.63, P < 0.001, r = -0.57, P < 0.01, and r = -0.36, P = 0.08). Glucose disposal was correlated with BMI during the 1.0 mU/kg min insulin infusion (r = -0.57, P < 0.05), and glucose production was correlated at the 0.4 mU/kg min infusion (r = 0.69, P < 0.01). We concluded that obesity diminishes the insulin sensitivity of both hepatic and peripheral tissues in patients with NIDDM. The exacerbation of the insulin resistance of NIDDM by obesity indicates why weight reduction is an effective treatment for the obese NIDDM patient.