Contributions of beta-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose.
Contributions of beta-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose.
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DOI：
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发表时间：
2006
期刊：
影响因子：
16.2
通讯作者：
M. Abdul-Ghani;D. Tripathy;R. DeFronzo
中科院分区：
文献类型：
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作者：
M. Abdul-Ghani;D. Tripathy;R. DeFronzo
葡萄糖耐量受损（IGT）和空腹葡萄糖受损（IFG）是正常葡萄糖耐受性和明显糖尿病之间存在的葡萄糖代谢中的中间状态。流行病学研究表明，这两个类别仅以部分重叠来描述不同的人群，这表明不同的代谢异常是IGT和IFG的特征。胰岛素抵抗和β细胞功能受损，在2型糖尿病中观察到的主要缺陷，都可以在患有IGT和IFG的受试者中检测到。但是，临床研究表明，两种疾病之间的胰岛素抵抗部位有所不同。虽然患有IGT的受试者仅具有轻度肝胰岛素抵抗具有明显的肌肉胰岛素抵抗，但IFG受试者具有严重的肝胰岛素耐药性，具有正常或几乎正常的肌肉胰岛素敏感性。 IFG和IGT的特征都是早期胰岛素分泌的降低，而患有IGT的受试者也损害了后期胰岛素的分泌。 IFG和IGT受试者中存在的不同代谢特征可能需要不同的治疗干预措施，以防止其发展为2型糖尿病。
Impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) are intermediate states in glucose metabolism that exist between normal glucose tolerance and overt diabetes. Epidemiological studies demonstrate that the two categories describe distinct populations with only partial overlap, suggesting that different metabolic abnormalities characterize IGT and IFG. Insulin resistance and impaired beta-cell function, the primary defects observed in type 2 diabetes, both can be detected in subjects with IGT and IFG. However, clinical studies suggest that the site of insulin resistance varies between the two disorders. While subjects with IGT have marked muscle insulin resistance with only mild hepatic insulin resistance, subjects with IFG have severe hepatic insulin resistance with normal or near-normal muscle insulin sensitivity. Both IFG and IGT are characterized by a reduction in early-phase insulin secretion, while subjects with IGT also have impaired late-phase insulin secretion. The distinct metabolic features present in subjects with IFG and IGT may require different therapeutic interventions to prevent their progression to type 2 diabetes.