INCREASED INSULIN CONCENTRATIONS IN NONDIABETIC OFFSPRING OF DIABETIC PARENTS
INCREASED INSULIN CONCENTRATIONS IN NONDIABETIC OFFSPRING OF DIABETIC PARENTS
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DOI：
10.1056/nejm198811173192001
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发表时间：
1988-11-17
影响因子：
158.5
通讯作者：
PATTERSON, JK
中科院分区：
文献类型：
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作者：
HAFFNER, SM;STERN, MP;PATTERSON, JK
胰岛素抵抗被许多人认为是导致非胰岛素依赖型糖尿病(NDDM)的主要缺陷。这一理论的一个含义是，糖尿病前期患者的血清胰岛素水平高于正常受试者。我们评估了1497名非糖尿病墨西哥裔美国人的血清胰岛素浓度，根据他们的父母或兄弟姐妹是否患有糖尿病，这是NIDDM的高危人群。据推测，糖尿病前期患者更有可能有强烈的糖尿病家族史。我们发现非糖尿病患者的空腹胰岛素水平在父母无糖尿病、单亲或双亲患有糖尿病的患者中逐步升高(分别为每升69.8pmoL、77.8pmoL和94.6pmol；P=0.002)。胰岛素和(空腹状态和75g口服葡萄糖负荷后30、60和120分钟的总胰岛素浓度)也观察到了类似的结果。在控制体重指数、体脂分布和血糖水平变化的协方差分析中，不同家族史的胰岛素和仍然具有统计学意义。有糖尿病兄弟姐妹的非糖尿病患者的空腹胰岛素浓度高于没有糖尿病兄弟姐妹的患者(每升83.2 pmol比69.6 pmoL)，但差异不具有统计学意义。我们得出的结论是，糖尿病前期患者在有更强糖尿病家族史的家庭中应该更多，他们患有高胰岛素血症。这支持了胰岛素抵抗假说。
Insulin resistance is thought by many to be the primary defect that results in non-insulin-dependent diabetes mellitus (NDDM). An implication of this theory is that prediabetic persons have higher serum insulin levels than normal subjects. We assessed serum insulin concentrations in a cohort of 1497 nondiabetic Mexican Americans, a population at high risk for NIDDM, according to whether their parents or siblings had diabetes. It was assumed that prediabetic persons would be more likely to have strong family histories of diabetes. We found a stepwise increase in fasting insulin levels in nondiabetics with neither, one, or both parents with diabetes (69.8, 77.8, and 94.6 pmol per liter, respectively; P = 0.002). Similar results were observed for insulin sum (the total of insulin concentrations in the fasting state and at 30, 60, and 120 minutes after a 75-g oral glucose load). The differences in insulin sums according to family history remained statistically significant in analyses of covariance, which controlled for variations in body-mass index, bodyfat distribution, and level of blood glucose. Subjects without diabetes who had a diabetic sibling had higher fasting concentrations of insulin than subjects without a diabetic sibling (83.2 vs. 69.6 pmol per liter), but the difference was not statistically significant. We conclude that prediabetic persons, who would be expected to be more numerous in kindreds with progressively stronger family histories of diabetes, have hyperinsulinemia. This supports the insulin-resistance hypothesis.