Early differential defects of insulin secretion and action in 19-year-old caucasian men who had low birth weight
Early differential defects of insulin secretion and action in 19-year-old caucasian men who had low birth weight
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DOI：
10.2337/diabetes.51.4.1271
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发表时间：
2002-04-01
期刊：
影响因子：
7.7
通讯作者：
Vaag, MA
中科院分区：
文献类型：
--
作者：
Jensen, CB;Storgaard, H;Vaag, MA
多项研究已将低出生体重 (LBW) 与 2 型糖尿病联系起来。我们研究了 40 名 19 岁男性（20 LBW，20 名匹配对照受试者）的肝脏和外周胰岛素作用，包括细胞内葡萄糖代谢，在两种生理胰岛素水平（10 和 40 mU/m(2) 每分钟）下使用高胰岛素-正常血糖钳夹技术、间接量热法和 [3(-3)H] 葡萄糖。在口服和静脉注射葡萄糖耐量试验期间检查胰岛素分泌。 LBW 组的空腹血糖较高（5.6 +/- 0.1 vs. 5.4 +/- 0.1；P < 0.05）。 LBW 组的基础血浆甘油浓度显着较低。 LBW组中胰岛素刺激的糖酵解通量显着减少，并且对内源性葡萄糖产生的抑制增强。然而，两组的全身外周葡萄糖处理、葡萄糖氧化、脂质氧化、外源葡萄糖储存和非氧化葡萄糖代谢的基础率和胰岛素刺激率相似。当相对于胰岛素敏感性（处置指数 = 胰岛素分泌 X 胰岛素作用）表示时，LBW 组的胰岛素分泌减少了 30%。我们认为，低出生体重男性中，胰岛素刺激的糖酵解减少先于明显的胰岛素抵抗。胰岛素分泌减少可能会导致葡萄糖耐量受损，并最终导致糖尿病。
Several studies have linked low birth weight (LBW) and type 2 diabetes. We investigated hepatic and peripheral insulin action including intracellular glucose metabolism in 40 19-year-old men (20 LBW, 20 matched control subjects), using the hyperinsulinemic-euglycemic clamp technique at two physiological insulin levels (10 and 40 mU/m(2) per min), indirect calorimetry, and [3(-3)H]glucose. Insulin secretion was examined during an oral and intravenous glucose tolerance test. Fasting p-glucose was higher in the LBW group (5.6 +/- 0.1 vs. 5.4 +/- 0.1; P < 0.05). Basal plasma glycerol concentrations were significantly lower in the LBW group. Insulin-stimulated glycolytic flux was significantly reduced, and suppression of endogenous glucose production was enhanced in the LBW group. Nevertheless, basal and insulin-stimulated rates of whole-body peripheral glucose disposal, glucose oxidation, lipid oxidation, exogenous glucose storage, and nonoxidative glucose metabolism were similar in the two groups. Insulin secretion was reduced by 30% in the LBW group, when expressed relative to insulin sensitivity (disposition index = insulin secretion X insulin action). We propose that reduced insulin-stimulated glycolysis precedes overt insulin resistance in LBW men. A lower insulin secretion may contribute to impaired glucose tolerance and ultimately lead to diabetes.