Tracer-determined glucose fluxes in health and type 2 diabetes: basal conditions
Tracer-determined glucose fluxes in health and type 2 diabetes: basal conditions
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DOI：
10.1016/s1521-690x(03)00038-1
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发表时间：
2003-09-01
影响因子：
7.4
通讯作者：
Pye, S
中科院分区：
文献类型：
--
作者：
Radziuk, J;Pye, S
基础葡萄糖生成（EGP）增加在2型糖尿病（DM2）高血糖症发病机制中的作用一直存在争议。这里提出的差异产生于：（i）不同的患者群体在疾病的发展的不同阶段，（ii）由于EGP的昼夜变化，在一天中的不同时间测量的非稳态，和（iii）实验技术的差异：示踪剂，启动策略和计算方法。方法上，我们表明，（i）非稳态方法和（ii）一个一室模型的分布容积估计示踪剂数据是必要的DM2。有足够数据的研究表明，EGP的日变化，在上午最高的利率，下午晚些时候正常化。葡萄糖代谢清除率（MCR）保持恒定。长期DM 2表现出高血糖增加和早晨EGP相对减少，可能是反馈诱导的。MCR失败，部分继发于葡萄糖毒性，可能诱导基线高血糖升高。
The role of increases in basal glucose production (EGP) in the pathogenesis of hyperglycaemia in type 2 diabetes (DM2) has been controversial. It is proposed here that the differences arose from: (i) different patient populations at different stages in the evolution of the disease, (ii) a non-steady state due to diurnal variations in EGP, and measurements at different times of day, and (iii) differences in experimental techniques: tracers, priming strategies and methods of calculation. Methodologically we show that (i) non-steady-state methods and (ii) a one-compartment model with volume of distribution estimated from tracer data are necessary in DM2. Studies with sufficient data demonstrated diurnal variations in EGP, with the highest rates in the morning, normalizing by late afternoon. Metabolic clearance rate of glucose (MCR) remained constant. Long-standing DM2 demonstrated increases in glycaemia and relative decreases in morning EGP, probably feedback-induced. A failing MCR, partly secondary to glucotoxicity, likely induced the rise in baseline hyperglycaemia.