Hepatic insulin clearance is increased in patients with high HbA1c type 2 diabetes: a preliminary report
Hepatic insulin clearance is increased in patients with high HbA1c type 2 diabetes: a preliminary report
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DOI：
10.1136/bmjdrc-2019-001149
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发表时间：
2020-01-01
影响因子：
4.1
通讯作者：
Yamamoto, Kazuhiro
中科院分区：
文献类型：
--
作者：
Okura, Tsuyoshi;Fujioka, Yohei;Yamamoto, Kazuhiro
前言肝脏胰岛素清除率（HIC）是2型糖尿病的重要病理生理机制。据报道，2型糖尿病和代谢综合征患者的HIC降低。然而，高血糖被认为会增加HIC，目前尚不清楚控制不良的糖尿病是否会增加2型糖尿病患者的HIC。我们调查了HIC是否增加，控制不佳的糖尿病患者，以及HIC是否与胰岛素抵抗和incretins.Research设计和方法我们进行了一餐耐量试验和高胰岛素-正葡萄糖钳夹在21例2型糖尿病患者。计算餐后C肽曲线下面积（AUC）与胰岛素AUC的比值作为HIC;测定空腹和餐后胰高血糖素样肽-1（GLP-1）、葡萄糖依赖性促胰岛素多肽（GIP）和胰高血糖素水平;分析血清脂联素和锌转运蛋白-8（ZnT 8）基因多态性。结果HIC与糖化血红蛋白（HbA 1c）显著相关（rs =0.58，p
Introduction Hepatic insulin clearance (HIC) is an important pathophysiology of type 2 diabetes. HIC was reported to decrease in patients with type 2 diabetes and metabolic syndrome. However, hyperglycemia was suggested to enhance HIC, and it is not known whether poorly controlled diabetes increases HIC in patients with type 2 diabetes. We investigated whether HIC was increased in patients with poorly controlled diabetes, and whether HIC was associated with insulin resistance and incretins.Research design and methods We performed a meal tolerance test and the hyperinsulinemic-euglycemic clamp in 21 patients with type 2 diabetes. We calculated the postprandial C-peptide area under the curve (AUC)-to-insulin AUC ratio as the HIC; measured fasting and postprandial glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and glucagon levels and analyzed serum adiponectin and zinc transporter-8 (ZnT8) gene polymorphism.Results The HIC significantly correlated with glycated hemoglobin (HbA1c) (r_S=0.58, p