Visceral fat dominant distribution in male type 2 diabetic patients is closely related to hepatic insulin resistance, irrespective of body type.
Visceral fat dominant distribution in male type 2 diabetic patients is closely related to hepatic insulin resistance, irrespective of body type.
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DOI：
10.1186/1475-2840-8-44
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发表时间：
2009-08-05
影响因子：
9.3
通讯作者：
DeFronzo RA
中科院分区：
文献类型：
--
作者：
Miyazaki Y;DeFronzo RA
所有研究腹部脂肪分布与胰岛素抵抗之间关系的既往研究均评价了皮下和内脏脂肪面积和/或体积，但这些值与每例受试者的体型无关。在本研究中，我们研究了腹部脂肪分布和周围（肌肉）/肝脏胰岛素敏感性之间的关联使用内脏腹部皮下脂肪面积比（VF/SF比）在男性2型糖尿病患者。这个比例定义了内脏或皮下腹部肥胖的优势，独立于每个个体的体型。36例男性2型糖尿病患者接受了正常血糖胰岛素钳夹（胰岛素输注速率= 40 mU/m2·min）和3- 3 H-葡萄糖，以测量胰岛素介导的全身（主要反映肌肉）葡萄糖处置（TGD）和内源性（主要反映肝脏）葡萄糖产生（EGP）对血浆胰岛素浓度生理性增加的反应。腹部皮下（SF）和腹内内脏脂肪（VF）面积在L4-5水平的磁共振成像（MRI）进行定量。TGD和TGD除以稳态胰岛素浓度（TGD/SSPI）与体重指数（BMI）、3 H2O法测量的总脂肪量（FM）、SF和VF面积呈负相关，而VF/SF比值与TGD或TGD/SSPI无显著相关性。与此相反，EGP和EGP与SSPI在胰岛素钳夹过程中的乘积（肝胰岛素抵抗指数）与VF/SF比值呈正相关，但与BMI、FM、VF或SF无关。我们的结论是，独立于个体的体型，内脏脂肪占主导地位的积累，而不是皮下脂肪积累与肝脏胰岛素抵抗，而外周（肌肉）胰岛素抵抗是更密切相关的一般肥胖（即更高的BMI和总FM，增加腹部SF和VF）在男性2型糖尿病患者。
All previous studies that investigated the association between abdominal fat distribution and insulin resistance evaluated subcutaneous and visceral fat area and/or volume, but these values were not related to the body type of each subject. In the present study we have examined the association between abdominal fat distribution and peripheral (muscle)/hepatic sensitivity to insulin using the visceral to abdominal subcutaneous fat area ratio (VF/SF ratio) in male patients with type 2 diabetes mellitus. This ratio defines the predominancy of visceral or subcutaneous abdominal adiposity, independent of the body type of each individual. Thirty-six type 2 diabetic male patients underwent a euglycemic insulin clamp (insulin infusion rate = 40 mU/m2·min) with 3-3H-glucose to measure insulin-mediated total body (primarily reflects muscle) glucose disposal (TGD) and suppression of endogenous (primarily reflects liver) glucose production (EGP) in response to a physiologic increase in plasma insulin concentration. Abdominal subcutaneous (SF) and intraabdominal visceral fat (VF) areas were quantitated with magnetic resonance imaging (MRI) at the level of L4–5. TGD and TGD divided by steady state plasma insulin concentration during the insulin clamp (TGD/SSPI) correlated inversely with body mass index (BMI), total fat mass (FM) measured by 3H2O, SF and VF areas, while VF/SF ratio displayed no significant relationship with TGD or TGD/SSPI. In contrast, EGP and the product of EGP and SSPI during the insulin clamp (an index hepatic insulin resistance) correlated positively with VF/SF ratio, but not with BMI, FM, VF or SF. We conclude that, independent of the individual's body type, visceral fat dominant accumulation as opposed to subcutaneous fat accumulation is associated with hepatic insulin resistance, whereas peripheral (muscle) insulin resistance is more closely related to general obesity (i.e. higher BMI and total FM, and increased abdominal SF and VF) in male patients with type 2 diabetes.
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DOI：
10.1016/j.jsbmb.2007.09.001
发表时间：
2008-02-01
影响因子：
4.1
作者：
Blouin, Karine;Boivin, Ariane;Tchernof, Andre
通讯作者：
Tchernof, Andre
影响因子：
9.8
作者：
CEFALU, WT;WANG, ZQ;ANDERSON, R
通讯作者：
ANDERSON, R
DOI：
10.1152/ajpendo.2001.280.6.e1000
发表时间：
2001-06-01
影响因子：
5.1
作者：
Basu, A;Basu, R;Jensen, MD
通讯作者：
Jensen, MD
影响因子：
5.8
作者：
Gautier, JF;Mourier, A;Cathelineau, G
通讯作者：
Cathelineau, G
影响因子：
5.8
作者：
Banerji, MA;Faridi, N;Lebovitz, HE
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Lebovitz, HE