beta-cell function in obesity: effects of weight loss.
beta-cell function in obesity: effects of weight loss.
复制标题
肥胖中的β细胞功能：减肥的影响。
作者：
E. Ferrannini;S. Camastra;A. Gastaldelli;Anna Maria Sironi;A. Natali;E. Muscelli;G. Mingrone;A. Mari
在非糖尿病受试者中，肥胖与β细胞质量的适度扩大有关，根据现有的最佳估计，每增加10公斤体重，β细胞质量可能增加10-30%。肥胖的发病年龄和持续时间、体重的近期变化和体脂分布是否对人类的β细胞质量有任何影响尚不清楚。空腹胰岛素分泌和口服葡萄糖总胰岛素应答均具有以下特点：1)与BMI呈近似线性关系增加，2)无脂量和脂肪量均显著正相关，3)BMI与胰岛素抵抗有正相关作用（即肥胖可能是原发性胰岛素高分泌状态）。其机制目前尚不清楚，尽管血浆葡萄糖的慢性小增量可能起作用。相反，β细胞功能的动态特性，如葡萄糖敏感性（即剂量-反应函数）、速率敏感性和增强，只要维持葡萄糖耐量，就不会因肥胖、体脂分布或胰岛素抵抗的存在而发生实质性改变。减肥，通过饮食或限制性减肥手术，与胰岛素抵抗和胰岛素高分泌的自愿下降有关。然而，后者似乎更持久，这表明肥胖后状态可能再现了肥胖状态的原发性胰岛素高分泌。相反，吸收不良减肥手术甚至在达到理想体重之前就能使胰岛素敏感性正常化，并消除胰岛素的高分泌。从胃肠道到胰岛素靶组织和内分泌胰腺的脂质触发信息是深入研究的主题。
In nondiabetic subjects, obesity is associated with a modest expansion of beta-cell mass, possibly amounting-according to the best available estimates-to 10-30% for each 10 kg of weight excess. Whether age of onset and duration of obesity, recent changes in body weight, and body fat distribution have any effect on beta-cell mass in humans is unknown. Both fasting insulin secretion and the total insulin response to oral glucose have the following characteristics: 1) they increase with BMI in an approximately linear fashion, 2) both fat-free and fat mass are significant positive correlates, and 3) BMI exerts a positive effect separate from that of insulin resistance (i.e., obesity may be a state of primary insulin hypersecretion). The mechanisms are currently unknown, though chronic small increments in plasma glucose may play a role. In contrast, dynamic properties of beta-cell function, such as glucose sensitivity (i.e., dose-response function), rate sensitivity, and potentiation, do not appear to be substantially altered by the presence of obesity, body fat distribution, or insulin resistance as long as glucose tolerance is maintained. Weight loss, by diet or restrictive bariatric surgery, is associated with consensual decrements in insulin resistance and insulin hypersecretion. The latter, however, seems to be more persistent, suggesting that the postobese state may reproduce the primary insulin hypersecretion of the obese state. Malabsorptive bariatric surgery, in contrast, normalizes insulin sensitivity and abolishes insulin hypersecretion even before achievement of ideal body weight. Lipid-triggered messages from the gastrointestinal tract to the insulin target tissues and endocrine pancreas are the subject of intense investigation.
DOI：
10.1210/jcem.77.5.8077323
发表时间：
1993-11
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
D. Kelley;R. Wing;Camille M. Buonocore;J. Sturis;K. Polonsky;M. D. Fitzsimmons
通讯作者：
D. Kelley;R. Wing;Camille M. Buonocore;J. Sturis;K. Polonsky;M. D. Fitzsimmons
DOI：
--
发表时间：
1994
期刊：
International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity
影响因子：
--
作者：
Valdez,R;Mitchell,BD;Haffner,SM;Hazuda,HP;Morales,PA;Monterrosa,A;Stern,MP
通讯作者：
Stern,MP