Diet-induced weight loss is associated with an improvement in β-cell function in older men
Diet-induced weight loss is associated with an improvement in β-cell function in older men
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DOI：
10.1210/jc.2003-031827
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发表时间：
2004-06-01
影响因子：
5.8
通讯作者：
Schwartz, RS
中科院分区：
文献类型：
--
作者：
Utzschneider, KM;Carr, DB;Schwartz, RS
尽管老年受试者的体重减轻已被证明可以改善胰岛素敏感性，但尚不清楚这种生活方式干预对β细胞功能的影响。为了确定饮食诱导的体重减轻是否可以改善老年受试者的β细胞功能，我们研究了19名健康男性受试者（年龄65.4 ± 0.9岁;体重指数30.9 ± 0.6 kg/m2;平均值± SEM）在3个月1200千卡/天饮食之前和之后。胰岛素敏感性指数（SI）采用Bergman最小模型定量。测定对葡萄糖的急性胰岛素反应（AIRg）和最大葡萄糖增强胰岛素反应（AIRmax），然后针对S-I进行调整（S-I x AIRg和S-I x AIRmax），从而提供β细胞功能的测量。受试者表现出显著的体重减轻（95.6 +/- 2.4至86.1 +/- 2.5 kg; P < 0.001）。空腹血糖[97.3 ± 1.6至95.1 ± 1.3 mg/dl（5.4 +/- 0.09至5.3 +/- 0.07 mM）; P = 0.05]和胰岛素18.5 +/- 1.3至12.2 +/- 1.0 mu U/ml（110.9 +/- 7.7至73.5 +/- 5.9 pM）; P < 0.001]水平降低。随着体重减轻，SI增加[1.59 +/- 0.24至2.49 +/- 0.32 x 10（-4）min（-1）/（muU/ml）]（2.65 +/- 0.4至4.15 +/- 0.5 x 10（-5）min（-1）/pM）; P < 0.001]，而AIRg [63.4 +/- 13.4至51.0 +/- 10.7 mu U/ml（380 +/- 80至306 +/- 64 pM）; P < 0.05]和AIRmax [ 314 +/- 31.4至259.9 +/- 33.4 muU/ml（1886 +/- 188至1560 +/- 200 pM）; P < 0.05]降低。总体β细胞功能改善（S-I x AIRg，9.63 +/- 2.28至12.78 +/- 2.58 x 10（-3）min（-1），P < 0.05; S-I x AIRmax，51.01 +/- 9.2至72.69 +/- 13.4 x 10（-3）min（-1），P < 0.05）。因此，与体重减轻相关的胰岛素敏感性和β细胞功能的改善可以解释生活方式干预对延缓老年受试者糖尿病发展的有益作用。
Although weight loss in older subjects has been shown to improve insulin sensitivity, it is unclear what effect this lifestyle intervention has on beta-cell function. To determine whether diet-induced weight loss can improve beta-cell function in older subjects, we studied 19 healthy male subjects ( age, 65.4 +/- 0.9 yr; body mass index, 30.9 +/- 0.6 kg/m(2); mean +/- SEM) before and after a 3-month 1200-kcal/d diet. The insulin sensitivity index ( SI) was quantified using Bergman's minimal model. The acute insulin response to glucose (AIRg) and the maximal glucose-potentiated insulin response (AIRmax) were determined and then adjusted for S-I (S-I x AIRg and S-I x AIRmax), thus providing measures of beta-cell function. Subjects demonstrated significant weight loss (95.6 +/- 2.4 to 86.1 +/- 2.5 kg; P < 0.001). Both fasting plasma glucose [97.3 +/- 1.6 to 95.1 +/- 1.3 mg/dl (5.4 +/- 0.09 to 5.3 +/- 0.07 mM); P = 0.05] and insulin 18.5 +/- 1.3 to 12.2 +/- 1.0 mu U/ml (110.9 +/- 7.7 to 73.5 +/- 5.9 pM); P < 0.001] levels decreased. With weight loss, SI increased [1.59 +/- 0.24 to 2.49 +/- 0.32 x 10(-4) min(-1)/(muU/ml) (2.65 +/- 0.4 to 4.15 +/- 0.5 x 10(-5) min(-1)/pM); P < 0.001], whereas both AIRg [63.4 +/- 13.4 to 51.0 +/- 10.7 mu U/ml ( 380 +/- 80 to 306 +/- 64 pM); P < 0.05] and AIRmax [ 314 +/- 31.4 to 259.9 +/- 33.4 muU/ml ( 1886 +/- 188 to 1560 +/- 200 pM); P < 0.05] decreased. Overall beta-cell function improved (S-I x AIRg, 9.63 +/- 2.28 to 12.78 +/- 2.58 x 10(-3) min(-1), P < 0.05; and S-I x AIRmax, 51.01 +/- 9.2 to 72.69 +/- 13.4 x 10(-3) min(-1), P < 0.05). Thus, the weight loss-associated improvements in both insulin sensitivity and beta-cell function may explain the beneficial effects of a lifestyle intervention on delaying the development of diabetes in older subjects.