Age, Glucose Intolerance, and Non—Insulin‐dependent Diabetes Mellitus
Age, Glucose Intolerance, and Non—Insulin‐dependent Diabetes Mellitus
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年龄、葡萄糖不耐症和非胰岛素依赖型糖尿病
DOI：
10.1111/j.1532-5415.1985.tb07118.x
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发表时间：
1985
影响因子：
6.3
通讯作者：
E. Reaven
中科院分区：
文献类型：
--
作者：
G. Reaven;E. Reaven
尽管胰岛素依赖型糖尿病（IDDM）可发生在老年患者中，但非胰岛素依赖型糖尿病（NIDDM）是迄今为止该年龄组中最常见的糖尿病形式。本文的主要目的是建立一个假设，解释为什么NIDDM的发病率随着年龄的增长而增加。为此，有必要回顾有关年龄对胰岛素分泌和胰岛素作用影响的现有信息，并提出目前关于NIDDM发病机制的观点。此外，还将关注随着年龄增长而发生的胰岛素分泌和作用变化对健康的影响。我希望这篇文章能给读者带来一些关于老问题的新见解。对我们的好处是相当大的，并且源于编写一份关于老年人口NIDDM的连贯文件的挑战。既然讲台是我们的，那么在一开始就宣布某些偏见是公平的。最重要的是，我们不认为仅仅考虑与衰老相关的碳水化合物代谢的变化就能对NIDDM对老年人的影响形成一个深思熟虑的观点。更具体地说，中年发生的事件（例如体重过度增加）可能在20年后产生深远的临床影响。将讨论限制在老年受试者的研究中可能被专业老年学家认为是“纯粹的”，但我们认为这会导致一种扭曲的观点，从而对我们将NIDDM对老年患者的有害影响最小化的能力产生不利影响。此外，我们认为将从动物研究中获得的信息与临床研究结果相结合是有益的。具体来说，在人类研究中难以或不可能回答的问题有时可以在动物研究中得到回答，因此积累的信息在各种领域都非常有用
Although insulin-dependent diabetes mellitus (IDDM) can occur in older patients, non-insulindependent diabetes mellitus (NIDDM) is by far the most common form of diabetes present in this age group. The primary goal of this article is to develop a hypothesis that explains why the incidence of NIDDM increases with age. To do so, it will be necessary to review available information pertaining to the effect of age on insulin secretion and insulin action and to present current views concerning the pathogenesis of NIDDM. In addition, attention will be directed to the health-related implications of the changes in insulin secretion and action that occur with aging. The benefit of this presentation to the reader will, it is hoped, be the acquisition of some new insights on an old issue. The benefit to us is considerable and stems from the challenge to prepare a coherent paper on NIDDM in the geriatric population. Since the rostrum is ours, it is only fair that certain prejudices be declared at the outset. Most important, we do not believe that one can develop a thoughtful view concerning the impact of NIDDM in the elderly by considering only the changes in carbohydrate metabolism associated with senescence. To be more specific, events that occur in middle life (excessive weight gain, for example) can have profound clinical effects 20 years later. Limiting discussion to studies of older subjects may be considered “pure” by the professional gerontologist, but we believe that this leads to a distorted view that can adversely affect our ability to minimize the deleterious effects of NIDDM in the older patient. In addition, we think it helpful to integrate information gained from animal studies with the results of clinical investigation. Specifically, questions that are difficult or iinpossible to answer in research on humans can sometimes be answered in animal studies, and the information thus accrued can be extremely useful in a variety
影响因子：
15.9
作者：
ROWE, JW;MINAKER, KL;FLIER, JS
通讯作者：
FLIER, JS