Adapting to insulin resistance in obesity: role of insulin secretion and clearance.
Adapting to insulin resistance in obesity: role of insulin secretion and clearance.
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DOI：
10.1007/s00125-017-4511-0
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发表时间：
2018-03
期刊：
影响因子：
8.2
通讯作者：
Kim SH
中科院分区：
文献类型：
--
作者：
Jung SH;Jung CH;Reaven GM;Kim SH
本研究的目的是量化胰岛素分泌率(ISR)增加和胰岛素清除率(ICR)降低在无糖尿病的胰岛素抵抗个体的代偿性高胰岛素血症特征中的相对贡献。肥胖(体重指数≥为30 kg/m2)非糖尿病患者(n=91)是从志愿者登记中确定的。志愿者接受了以下测量：口服葡萄糖耐量；胰岛素抵抗(胰岛素抑制试验期间的稳态血糖[SSPG]浓度)；ISR(使用分级葡萄糖输注试验[GGIT])；ICR(使用IST和GGIT)。参与者根据SSPG浓度分为三组：SSPG-1(胰岛素敏感组)、SSPG-2(中间组)和SSPG-3(胰岛素抵抗组)。SSPG人群的BMI和腰围差异无统计学意义。SSPG-2和SSPG-3组血清丙氨酸氨基转移酶浓度高于SSPG-1组(p=0.02)。在口服葡萄糖刺激后，从对胰岛素最敏感的患者到最不耐受的患者，总的综合胰岛素反应逐渐增加(p<；0.001)。静脉注射葡萄糖后，SSPG-3组的血糖积分(中位数[四分位数范围]，32.9[30.8-36.3]mmol/L×h)和胰岛素反应(1711[1476-2223]mmol/L×h)显著高于SSPG-1组(分别为30.3[28.8-32.9]mmol/L×h，p=0.04和851[600-1057]pmol/L×h，p<；0.001)。此外，只有SSPG-3组的ISR和ICR都有显著变化(p<；0.001)。SSPG-2组仅ICR较SSPG-1组显著降低。因此，随着胰岛素抵抗的增加，ICR在IST期间逐渐下降(SSPG-1，0.48[0.41-0.59]；SSPG-2，0.43[0.39-0.50]；SSPG-3，0.34[0.31-0.40])。虽然ISR的增加和ICR的减少都能弥补胰岛素抵抗，但ICR的减少可能是对胰岛素敏感性降低的第一个适应。
The aim of this study was to quantify the relative contributions of increased insulin secretion rate (ISR) and decreased insulin clearance rate (ICR) in the compensatory hyperinsulinaemia characteristic of insulin-resistant individuals without diabetes. Obese (BMI ≥30 kg/m2) individuals without diabetes (n = 91) were identified from a registry of volunteers. Volunteers underwent the following measurements: oral glucose tolerance; insulin resistance (steady-state plasma glucose [SSPG] concentration during the insulin suppression test [IST]); ISR (using the graded glucose infusion test [GGIT]); and ICR (using the IST and GGIT). Participants were stratified into tertiles based on SSPG concentration: SSPG-1(insulin-sensitive); SSPG-2 (intermediate); and SSPG-3 (insulin-resistant). There were no differences in BMI and waist circumference among the SSPG tertiles. Serum alanine aminotransferase concentrations were higher in the SSPG-2 and SSPG-3 groups compared with the SSPG-1 group (p = 0.02). Following an oral glucose challenge, there was a progressive increase in the total integrated insulin response from the most insulin-sensitive to the most insulin-resistant tertiles (p < 0.001). Following intravenous glucose, the SSPG-3 group had significantly greater integrated glucose (median [interquartile range], 32.9 [30.8–36.3] mmol/l × h) and insulin responses (1711 [1476–2223] mmol/l × h) compared with the SSPG-1 group (30.3 [28.8–32.9] mmol/l × h, p = 0.04, and 851 [600–1057] pmol/l × h, p < 0.001, respectively). Furthermore, only the SSPG-3 group had significant changes in both ISR and ICR (p < 0.001). In the SSPG-2 group, only the ICR was significantly decreased compared with the SSPG-1 group. Therefore, ICR progressively declined during the IST with increasing insulin resistance (SSPG-1, 0.48 [0.41–0.59]; SSPG-2, 0.43 [0.39–0.50]; SSPG-3, 0.34 [0.31–0.40]). While both increases in ISR and decreases in ICR compensate for insulin resistance, decreases in ICR may provide the first adaptation to decreased insulin sensitivity.
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影响因子：
9.8
作者：
Knowles, Joshua W.;Assimes, Themistocles L.;Abbasi, Fahim
通讯作者：
Abbasi, Fahim
影响因子：
7.7
作者：
Kim, SH;Abbasi, F;Reaven, GM
通讯作者：
Reaven, GM
影响因子：
7.7
作者：
GREENFIELD, MS;DOBERNE, L;REAVEN, G
通讯作者：
REAVEN, G
影响因子：
5.8
作者：
Jones, CNO;Pei, D;Reaven, GM
通讯作者：
Reaven, GM
DOI：
10.1152/ajpendo.00444.2007
发表时间：
2007-12-01
影响因子：
5.1
作者：
Kotronen, Anna;Vehkavaara, Satu;Yki-Jarvinen, Hannele
通讯作者：
Yki-Jarvinen, Hannele