Impact of Insufficient Insulin Secretion on Subclinical Glucose Dysregulation
Impact of Insufficient Insulin Secretion on Subclinical Glucose Dysregulation
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DOI：
10.11320/ningendock.25.37
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发表时间：
2011-03
期刊：
影响因子：
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通讯作者：
C. Yamada;T. Mitsuhashi;N. Hiratsuka;Fumiyo Inabe;Nami Araida;Eiko Takahashi
中科院分区：
文献类型：
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作者：
C. Yamada;T. Mitsuhashi;N. Hiratsuka;Fumiyo Inabe;Nami Araida;Eiko Takahashi
背景阐明与增加胰岛素抵抗和aging.Methods的影响，胰岛素分泌不足的亚临床葡萄糖失调，我们进行了一项横断面研究，3950日本受试者使用稳态模型评估（HOMA）衍生的指数。我们根据胰岛素抵抗或年龄组比较β细胞功能。结果胰岛素抵抗增加导致血糖升高，胰岛素分泌明显增加，但代偿性胰岛素分泌不足以抑制亚临床血糖升高。沿着衰老，空腹血糖升高，血清胰岛素水平无变化，β细胞功能的HOMA衍生指数显著降低。双向方差分析显示，胰岛素抵抗和增龄是影响胰岛β细胞功能的独立因素，且胰岛素抵抗对胰岛β细胞功能的影响比增龄更显著。结论胰岛β细胞功能障碍是决定葡萄糖代谢的主要因素，即使血糖水平上升到“高正常”范围，胰岛β细胞分泌不足也已存在。应评价胰岛素分泌与胰岛素抵抗的关系，因为观察到的胰岛素分泌可能不足以调节血糖浓度。（《Ningen Dock》2011年; 25：37-44）
Background To elucidate the impact of insufficient insulin secretion on subclinical glucose dysregulation in association with increased insulin resistance and aging.Methods We conducted a cross-sectional study of 3950 Japanese subjects using homeostasis model assessment (HOMA)-derived indices. We compared β-cell function according to insulin resistance or age groups. Interaction between insulin resistance and aging on β-cell function was assessed using two-way analysis of variance (ANOVA).Results Increased insulin resistance resulted in higher blood glucose levels and apparently higher insulin secretion, but compensatory insulin secretion was considered insufficient to suppress subclinical blood glucose elevation. Along with aging, fasting blood glucose became higher without changes in serum insulin levels and HOMA-derived indices for β-cell function significantly decreased. Two-way ANOVA revealed that insulin resistance and aging independently influenced β-cell function and the effects of insulin resistance on β-cell function were more dominant than those of aging.Conclusion Our study shows that β-cell dysfunction is a major contributor in determining glucose disposal and insufficient insulin secretion is already present even when glucose levels rise into the “highnormal” range. Insulin secretion should be evaluated in relation to insulin resistance, as the observed insulinsecretion may be insufficient to adjust plasma glucose concentrations.(Ningen Dock 2011; 25: 37-44)