The effect of insulin resistance and hepatic insulin clearance on the risk of non-insulin-dependent diabetes mellitus.

胰岛素抵抗和肝脏胰岛素清除率对非胰岛素依赖型糖尿病风险的影响。

• 批准号: 11670389
• 负责人: SHIMADA Naoki
• 金额: $ 2.05万
• 依托单位: KEIO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2000
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-11670389/
• 关键词: non-insulin-dependent diabetes mellitus; insulin; C-peptide; insulin resistance; HOMA model; insulin clearance; body mass index; waist-to-hip ratio; 糖尿病; 全身性肥満; 中心性肥満; 耐糖能異常; 肝インシュリンクリアランス; コホート研究

Purpose : To investigate the effect of insulin resistance and hepatic insulin clearance on the risk of non-insulin-dependent diabetes mellitus among the Japanese male workers.Subjects and Methods : The study subjects were recruited from the employees of a railway company. There were 1805 eligible subjects for the following analysis who fitted in the inclusion criteria (1 : Fasting venipuncture, 2 : Existence of glucose, insulin, and C-peptide data, 3 : Sufficient anthromopetric data, such as height, weight, and waist and hip circumferences). The subjects were classified into diabetics or non-diabetics. Body mass index (BMI), which was defined as weight (kg) divided by the square of height (m), Waist-to-hip ratio, and liver dysfunction (GOT≧40 IU and/or GPT≧35 IU) were treated as potential confounding factors. Student's t-test was employed in order to examine the difference of the mean value of variables between diabetics and non-diabetics. The effect of insulin resistance (HOMA) and C-peptide-to-insulin ratio, which reflected hepatic insulin clearance, on the risk of diabetes was examined by means of multiple logistic regression analysis. P-values less than 0.05 were used as significant.Results : Waist-to-hip ratio, insulin, insulin resistance were significantly high among the diabetics compared with the non-diabetics. C-peptide-to-insulin ratio was significantly low among the diabetics. One unit increase of insulin resistance showed 1.19times risk of diabetes, independent of general and abdominal obesity and liver dysfunction. On the other hand, 1 unit increase of C-peptide-to-insulin ratio improved the risk of diabetes.Conclusion : Insulin resistance and hepatic insulin clearance may affect the risk of diabetes, respectively positively or inversely, independent of obesity and liver dysfunction. This finding may suggest another pathway into the development of diabetes.

目的：探讨日本男性工人胰岛素抵抗和肝脏胰岛素清除率对非胰岛素依赖型糖尿病风险的影响。有1805例符合入选标准的合格受试者可用于以下分析（1：空腹静脉穿刺，2：存在葡萄糖、胰岛素和C肽数据，3：足够的人体测量数据，如身高、体重、腰围和臀围）。受试者分为糖尿病患者和非糖尿病患者。将体重指数（BMI）（定义为体重（kg）除以身高（m）的平方）、腰臀比和肝功能障碍（GOT ≤ 40 IU和/或GPT ≤ 35 IU）作为潜在混杂因素。采用学生t检验，以检查糖尿病患者和非糖尿病患者之间的变量的平均值的差异。胰岛素抵抗（HOMA）和C-肽-胰岛素比，反映了肝脏胰岛素清除率，对糖尿病的风险的影响进行了研究，通过多元Logistic回归分析。结果：糖尿病患者腰臀比、胰岛素、胰岛素抵抗均显著高于非糖尿病患者。糖尿病患者的C-肽与胰岛素的比例明显较低。胰岛素抵抗增加一个单位，患糖尿病的风险就增加1.19倍，与全身和腹部肥胖以及肝功能障碍无关。结论：胰岛素抵抗和肝脏胰岛素清除率可能分别与糖尿病的发病风险成正相关或负相关，与肥胖和肝功能异常无关。这一发现可能暗示了糖尿病发展的另一条途径。