The effect of age on insulin resistance and secretion: a review.
The effect of age on insulin resistance and secretion: a review.
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DOI：
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发表时间：
1996-07
影响因子：
3.3
通讯作者：
D. Muller;D. Elahi;J. Tobin;R. Andres
中科院分区：
文献类型：
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作者：
D. Muller;D. Elahi;J. Tobin;R. Andres
衰老与高血压、非胰岛素依赖型糖尿病和冠心病的发病率增加有关。由于这些病症通常集中在同一个人身上，因此有人猜测，所有这些病理状态都是由一个共同的机制造成的。流行病学和临床研究均表明，胰岛素抵抗和/或高胰岛素血症与葡萄糖不耐受、血脂异常（高血浆甘油三酯和低高密度脂蛋白胆固醇水平）以及较高的收缩压和舒张压有关。因此，胰岛素抵抗和高胰岛素血症被认为是上述簇元素之间的因果关系，现在最常被称为胰岛素抵抗综合征、X综合征或代谢综合征。老年人更容易出现葡萄糖不耐症和胰岛素抵抗，但这种功能下降是否是“生物衰老”不可避免的结果，还是所谓环境或生活方式变量的结果：肥胖增加、脂肪分布的有害模式或通常伴随年龄增长的身体缺乏活动，仍然存在争议。所有这些可改变的环境因素也已被证明会导致胰岛素抵抗和高胰岛素血症的增加，并且是代谢综合征疾病发展的危险因素。最近试图扭转老年人这些状况的介入研究表明，胰岛素敏感性和葡萄糖耐量有所改善。另一方面，即使在调整了肥胖、脂肪分布和体力活动的差异后，胰岛素分泌似乎也会随着年龄的增长而减少。这可能是导致老年人出现葡萄糖不耐症的原因，即使他们的生活方式变量已经得到改善。
Aging is associated with an increased incidence of hypertension, noninsulin-dependent diabetes mellitus, and coronary heart disease. Because these conditions often cluster in the same individuals, there has been speculation that a common mechanism is responsible for all of these pathological states. Both epidemiological and clinical research has shown that insulin resistance and/or hyperinsulinemia are associated with glucose intolerance, dyslipidemia (high plasma triglyceride and low high-density lipoprotein-cholesterol levels), and higher systolic and diastolic blood pressures. Therefore, insulin resistance and hyperinsulinemia have been proposed as the causal link among the elements of the cluster mentioned above, now most commonly referred to as the insulin resistance syndrome, syndrome X, or the metabolic syndrome. The elderly are more glucose intolerant and insulin-resistant, but it remains controversial whether this decrease in function is an inevitable consequence of "biological aging" or the result of what might be referred to as environmental or lifestyle variables: increased obesity, a detrimental pattern of fat distribution, or physical inactivity that usually accompany age. All of these modifiable environmental factors have also been shown to result in increases in insulin resistance and hyperinsulinemia and are risk factors for the development of the diseases of the metabolic syndrome. Recent interventional studies that have attempted to reverse these conditions in the elderly have shown improved insulin sensitivity, and glucose tolerance. Insulin secretion, on the other hand, seems to decrease with age even after adjustments for differences in adiposity, fat distribution, and physical activity. This may be responsible for the glucose intolerance in the very old even after improvements have been made in their lifestyle variables.