The relationship between {beta}-cell function and glycated hemoglobin: results from the veterans administration genetic epidemiology study.
The relationship between {beta}-cell function and glycated hemoglobin: results from the veterans administration genetic epidemiology study.
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DOI：
10.2337/dc10-1352
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发表时间：
2011-04
期刊：
影响因子：
16.2
通讯作者：
Abdul-Ghani MA
中科院分区：
文献类型：
--
作者：
Kanat M;Winnier D;Norton L;Arar N;Jenkinson C;Defronzo RA;Abdul-Ghani MA
研究目的是评估β细胞功能与HbA1c之间的关系。共有522名墨西哥裔美国人参与了本研究。每位受试者在禁食10- 12小时后接受75克口服葡萄糖耐量试验（OGTT）。用松田指数评估胰岛素敏感性。通过血浆c肽浓度的反褶积来定量胰岛素分泌率。β-通过胰岛素分泌/胰岛素抵抗（IS/IR）（处置）指数评估细胞功能，并与HbA1c水平相关。在HbA1c <5.5%时，胰岛素敏感性Matsuda指数和IS/IR指数不变。然而，随着HbA1c升高5.5%，Matsuda指数和IS/IR指数均急剧下降。与HbA1c <5.5%组相比，HbA1c = 6.0 ~ 6.4%组的Matsuda指数和IS/IR指数分别下降了44%和74% （P < 0.01）。糖耐量正常且HbA1c <5.7%的受试者β细胞功能与糖耐量正常且HbA1c = 5.7-6.4%的受试者相当。然而，空腹血糖受损或糖耐量受损的受试者β细胞功能明显下降，与HbA1c水平无关。本研究结果表明，在墨西哥裔美国人中，当HbA1c升高6.0%时，胰岛素敏感性和β细胞功能均显著下降。进行OGTT对于准确识别β细胞功能受损的受试者至关重要。
The study objective was to assess the relationship between β-cell function and HbA1c. A total of 522 Mexican American subjects participated in this study. Each subject received a 75-g oral glucose tolerance test (OGTT) after a 10- to 12-h overnight fast. Insulin sensitivity was assessed with the Matsuda index. Insulin secretory rate was quantitated from deconvolution of the plasma C-peptide concentration. β-Cell function was assessed with the insulin secretion/insulin resistance (IS/IR) (disposition) index and was related to the level of HbA1c. At HbA1c levels <5.5%, both the Matsuda index of insulin sensitivity and IS/IR index were constant. However, as the HbA1c increased >5.5%, there was a precipitous decrease in both the Matsuda index and the IS/IR index. Subjects with HbA1c = 6.0–6.4% had a 44 and 74% decrease in the Matsuda index and the IS/IR index, respectively, compared with subjects with HbA1c <5.5% (P < 0.01 for both indices). Subjects with normal glucose tolerance and HbA1c <5.7% had β-cell function comparable to that of subjects with normal glucose tolerance with HbA1c = 5.7–6.4%. However, subjects with impaired fasting glucose or impaired glucose tolerance had a marked decrease in β-cell function independent of their HbA1c level. The results of the current study demonstrate that in Mexican Americans, as HbA1c increases >6.0%, both insulin sensitivity and β-cell function decrease markedly. Performing an OGTT is pivotal for accurate identification of subjects with impaired β-cell function.