The metabolic responses induced by acute dexamethasone predict glucose tolerance and insulin secretion over 10years in relatives of type 2 diabetic subjects
The metabolic responses induced by acute dexamethasone predict glucose tolerance and insulin secretion over 10years in relatives of type 2 diabetic subjects
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DOI：
10.1002/dmrr.2418
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发表时间：
2013-09-01
影响因子：
8
通讯作者：
Alford, Frank P.
中科院分区：
文献类型：
--
作者：
Durck, Tina Trier;Henriksen, Jan Erik;Alford, Frank P.
背景本研究旨在比较2型糖尿病患者正常血糖亲属和健康对照者对地塞米松的代谢和胰岛素分泌反应与10年时观察到的代谢反应（地塞米松治疗前和治疗后）和10岁时，采用75 g口服葡萄糖耐量试验（OGTT），连续测量葡萄糖和胰岛素，用于测定葡萄糖耐量和计算急性胰岛素释放（I-30/G（30）;结果服用地塞米松后，亲属组出现不同程度的糖耐量异常，与胰岛素敏感性和胰岛素生成指数降低有关。到10岁时，亲属组的空腹血糖和2小时OGTT血糖升高，尤其是受地塞米松代谢影响最大的亲属，包括胰岛素生成指数降低。多元回归分析显示，10年时的2 h OGTT血糖和空腹血糖值与0年后的2 h OGTT血糖、空腹血糖和胰岛素敏感性相关，r（adj）（2）=56%（p <0.05）。
Background This study aimed to compare the metabolic and insulin secretory responses to dexamethasone with the metabolic responses observed at 10years in normoglycaemic relatives of type 2 diabetic and healthy control subjects.Methods Twenty relatives and 20 matched control subjects were studied twice at 0year (pre- and post-dexamethasone) and at 10years, employing a 75-g oral glucose tolerance test (OGTT), with serial measurements of glucose and insulin, for determination of glucose tolerance and calculations of acute insulin release (I-30/G(30); insulinogenic index) and insulin sensitivity (SIHOMA).Results Following dexamethasone, the relatives group developed varying degrees of glucose intolerance, associated with reduced insulin sensitivity and insulinogenic index. By 10years, fasting glucose and 2-h OGTT glucose were raised in the relatives group, especially in the relatives most metabolically affected by dexamethasone, including a reduced insulinogenic index. Multiple regression analysis of the data in relatives demonstrated that the 2-h OGTT glucose and fasting glucose values at 10years depended on the 0-year post-dexamethasone 2-h OGTT glucose, post-dexamethasone fasting glucose and post-dexamethasone insulin sensitivity, r(adj)(2)=56% (p