Evidence for early defects in insulin sensitivity and secretion before the onset of glucose dysregulation in obese youths: a longitudinal study.
Evidence for early defects in insulin sensitivity and secretion before the onset of glucose dysregulation in obese youths: a longitudinal study.
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作者：
Giannini C;Weiss R;Cali A;Bonadonna R;Santoro N;Pierpont B;Shaw M;Caprio S
我们试图确定肥胖青少年在口服葡萄糖耐量试验后2小时血糖水平高的情况下是否表现出胰岛素分泌缺陷和敏感性与糖耐量受损(IGT)的未来发展相关。将60例正常糖耐量(NGT)肥胖青少年按2小时血糖值(100、100-119、120-139 mg/dL)分为3组和21例IGT肥胖青少年，用高胰岛素-正常血糖钳夹法检测胰岛素敏感性，并用数学模型模拟高血糖钳夹下胰岛素分泌。糖耐量在两年后重新评估。在两小时血糖NGT类别中，胰岛素敏感性显著降低，而最高NGT类别和IGT组相似。在所有NGT类别中，第一时相胰岛素分泌减少，而最高NGT组和IGT受试者之间没有发现差异。在所有NGT和IGT组中，第二时相分泌相似。倾向指数(CDI)在NGT类别中下降，而NGT和IGT最高的受试者之间没有差异。年龄和CDI是预测两年后2-h血糖的最佳指标。在正常的2-h血糖水平升高的类别中，与与糖耐量低减相关的胰岛素敏感性相关，NGT肥胖青少年表现出显著的β细胞功能损害。
We sought to determine whether obese adolescents with high-“normal” 2-h post-oral glucose tolerance test glucose levels display defects in insulin secretion and sensitivity associated with future development of impaired glucose tolerance (IGT). Insulin sensitivity was measured by hyperinsulinemic-euglycemic clamp and insulin secretion by applying mathematical modeling during the hyperglycemic clamp in 60 normal glucose tolerance (NGT) obese adolescents, divided into three groups based on the 2-h glucose values (<100, 100–119, 120–139 mg/dL), and in 21 IGT obese adolescents. Glucose tolerance was reevaluated after 2 years. Insulin sensitivity decreased significantly across 2-h glucose NGT categories, while the highest NGT category and IGT group were similar. First-phase insulin secretion decreased across NGT categories, while no difference was found between the highest NGT group and IGT subjects. Second-phase secretion was similar across all NGT and IGT groups. The disposition index (CDI) decreased across NGT categories, while no difference was observed between the highest NGT and IGT subjects. Age and CDI were the best predictors of 2-h glucose after two years. Across rising categories of normal 2-h glucose levels, NGT obese adolescents exhibit significant impairment of β-cell function relative to insulin sensitivity associated with the development of IGT.
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影响因子：
16.2
作者：
通讯作者：
--
影响因子：
168.9
作者：
Weiss, R;Dufour, S;Caprio, S
通讯作者：
Caprio, S
影响因子：
16.2
作者：
Cali AM;Man CD;Cobelli C;Dziura J;Seyal A;Shaw M;Allen K;Chen S;Caprio S
通讯作者：
Caprio S
影响因子：
5.8
作者：
Cali, Anna M. G.;Bonadonna, Riccardo C.;Caprio, Sonia
通讯作者：
Caprio, Sonia
影响因子：
6.8
作者：
AKAIKE, H
通讯作者：
AKAIKE, H