Adipose tissue distribution in relation to insulin resistance in type 2 diabetes mellitus
Adipose tissue distribution in relation to insulin resistance in type 2 diabetes mellitus
复制标题
DOI：
10.1152/ajpendo.00394.2006
复制
发表时间：
2007-07-01
影响因子：
5.1
通讯作者：
Kelley, David E.
中科院分区：
文献类型：
--
作者：
Azuma, Koichiro;Heilbronn, Leonie K.;Kelley, David E.
胰岛素抵抗（IR）通常在肥胖的2型糖尿病（T2 DM）患者中比在类似的肥胖的非糖尿病患者中更严重，但是否存在身体组成的组差异以及这些差异是否导致T2 DM的更严重IR尚不确定。对67名T2 DM受试者（F39/M28，年龄60 ± 7岁，BMI 34 ± 3 kg/m2）和35名类似肥胖的非DM志愿者（F20/M15，年龄55 ± 8岁，BMI 33 ± 2 kg/m2）进行DEXA和局部CT成像，以评估肝脏和肌肉中的脂肪组织（AT）分布和脂肪含量。对皮下腹部AT进行活检以测量脂肪细胞大小。在80 mU-mm（-1.）m（-2）。T2 DM患者的IR更严重（6.1 +/- 2.3 vs 9.9 +/- 3.3 mg（.）最小值（-1.）kg FFM-1; P < 0.01）。在调整年龄、性别、种族、身高和总脂肪量（FM）的影响后，进行身体成分参数的组间比较。2型糖尿病患者的腿部FM较低（-1.2 +/-0.4 kg，P < 0.01），躯干FM较多（+1.1 +/-0.4 kg，P < 0.05），肝脏脂肪较多（P < 0.05），骨骼肌周围筋膜下脂肪组织较多（P < 0.05）。组间性别差异有统计学意义（P < 0.01），女性T2 DM患者的VAT更高（P < 0.01）。各组间平均脂肪细胞大小（AS）无显著差异，较小的AS与腿部FM增加相关，而较大的AS与躯干FM增加相关（均P < 0.05）。在调整腿部FM、躯干FM和肝脏脂肪的组间差异后，IR的组间差异较小，但这些调整仅部分解释了T2 DM中IR的更严重程度。总之，与相似的肥胖非糖尿病男性和女性相比，T2 DM与腿部FM较少、躯干FM和肝脏脂肪较多相关。
Insulin resistance (IR) is typically more severe in obese individuals with type 2 diabetes (T2DM) than in similarly obese non-diabetics but whether there are group differences in body composition and whether such differences contribute to the more severe IR of T2DM is uncertain. DEXA and regional CT imaging were conducted to assess adipose tissue (AT) distribution and fat content in liver and muscle in 67 participants with T2DM (F39/M28, age 60 +/- 7 yr, BMI 34 +/- 3 kg/m(2)) and in 35 similarly obese, non-DM volunteers (F20/M15, age 55 +/- 8 yr, BMI 33 +/- 2 kg/m(2)). A biopsy of subcutaneous abdominal AT was done to measure adipocyte size. A glucose clamp was performed at an insulin infusion of 80 mU-mm(-1.) m(-2). There was more severe IR in T2DM (6.1 +/- 2.3 vs. 9.9 +/- 3.3 mg(.)min(-1.)kg FFM-1; P < 0.01). Group comparisons of body composition parameters was performed after adjusting for the effect of age, gender, race, height and total fat mass (FM). T2DM was associated with less leg FM (-1.2 +/- 0.4 kg, P < 0.01), more trunk FM (+1.1 +/- 0.4 kg, P < 0.05), greater hepatic fat (P < 0.05), and more subfascial adipose tissue around skeletal muscle (P < 0.05). There was a significant group X sex interaction for VAT (P < 0.01), with greater VAT in women with T2DM (P < 0.01). Mean adipocyte size (AS) did not significantly differ across groups, and smaller AS was associated with increased leg FM, whereas larger AS was related to more trunk FM (both P < 0.05). Group differences in IR were less after adjusting for group differences in leg FM, trunk FM, and hepatic fat, but these adjustments only partially accounted for the greater severity of IR in T2DM. In summary, T2DM, compared with similarly obese nondiabetic, men and women, is associated with less leg FM and greater trunk FM and hepatic fat.