Is reduced first-phase : Insulin release the earliest detectable abnormality in individuals destined to develop type 2 diabetes?
Is reduced first-phase : Insulin release the earliest detectable abnormality in individuals destined to develop type 2 diabetes?
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DOI：
10.2337/diabetes.51.2007.s117
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发表时间：
2002-02-01
期刊：
影响因子：
7.7
通讯作者：
Gerich, JE
中科院分区：
文献类型：
--
作者：
Gerich, JE
响应于动脉葡萄糖浓度的方波增加，胰岛素以双相方式从胰腺释放。第一阶段包括持续大约 10 分钟的短暂峰值，然后是第二阶段，在 2-3 小时达到稳定水平。人们普遍认为，第一相胰岛素释放的减少是注定要发展为 2 型糖尿病的个体中最早可检测到的 β 细胞功能缺陷，并且这种缺陷很大程度上代表了 β 细胞在对先前的胰岛素抵抗进行多年补偿后的耗竭。在这篇文章中，回顾了这些概念的起源，并提出了最近的证据，表明胰岛素释放的两个阶段的减少同样早，它们先于胰岛素抵抗，而不仅仅是由于肥胖，因此它们可能代表了个体易患 2 型糖尿病的主要遗传风险因素。
Insulin is released from the pancreas in a biphasic manner in response to a square-wave increase in arterial glucose concentration. The first phase consists of a brief spike lasting similar to10 min followed by the second phase, which reaches a plateau at 2-3 h. It is widely thought that diminution of first-phase insulin release is the earliest detectable defect of beta-cell function in individuals destined to develop type 2 diabetes and that this defect largely represents beta-cell exhaustion after years of compensation for antecedent insulin resistance. In this article, the origins of these concepts are reviewed and recent evidence is presented suggesting that reductions in both phases of insulin release are equally early, that they precede insulin resistance other than that simply due to obesity, and that they therefore may represent the primary genetic risk factor predisposing individuals to type 2 diabetes.