Insulin secretion and insulin sensitivity pattern is different in isolated impaired glucose tolerance and impaired fasting glucose - The risk factor in impaired glucose tolerance for atherosclerosis and diabetes study
Insulin secretion and insulin sensitivity pattern is different in isolated impaired glucose tolerance and impaired fasting glucose - The risk factor in impaired glucose tolerance for atherosclerosis and diabetes study
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DOI：
10.2337/diacare.26.3.868
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发表时间：
2003-03-01
期刊：
影响因子：
16.2
通讯作者：
Temelkova-Kurktschiev, T
中科院分区：
文献类型：
--
作者：
Hanefeld, M;Koehler, C;Temelkova-Kurktschiev, T
目的：单纯空腹血糖受损（IFG）和糖耐量受损（IGT）是2型糖尿病的两种危险类型.这项研究比较了这两个类别相对于胰岛素分泌异常和insulin resistance.RESEARCH设计和方法的程度-这是一个交叉比较的人口在高风险的2型糖尿病。受试者是从动脉粥样硬化和糖尿病（RIAD）研究中的葡萄糖耐量受损风险因素中招募的。他们接受了75克口服葡萄糖耐量试验，在基线和负荷后每30分钟测量特异性胰岛素、C肽、胰岛素原和游离脂肪酸，持续2小时。因子分析进行评估的重要性，胰岛素抵抗和分泌异常，在这两个category.RESULTS -所有类别的糖尿病前期高血糖症有较高的心血管危险因素水平时，调整性别，年龄和体重指数相比，控制受试者与正常的葡萄糖耐量。单纯IFG组胰岛素抵抗程度高于IGT组。相比之下，与IFG受试者相比，孤立性IGT受试者在早期和晚期胰岛素分泌方面表现出更严重的缺陷。如因子分析所示，IFG中胰岛素抵抗因子解释了28.4%的方差，而IGT中胰岛素分泌因子占主导地位，解释了31.1%的总variation.CONCLUSIONS -我们的横截面数据从RIAD研究表明，孤立IFG和孤立IGT是不同的胰岛素抵抗和胰岛素分泌异常的程度，并且IGT受试者在胰岛素分泌的早期和晚期表现出缺陷。这一发现对于2型糖尿病一级预防的差异化方法可能很重要。
OBJECTIVE - isolated impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are two risk categories for type 2 diabetes. This study compared both categories With respect to the degree of insulin secretion abnormalities and insulin resistance.RESEARCH DESIGN AND METHODS - This is a crossover comparison of a population at high risk for type 2 diabetes. The subjects were recruited from the Risk Factor in Impaired Glucose Tolerance for Atherosclerosis and Diabetes (RIAD) study. They underwent a 75-g oral glucose tolerance test, with measurement of specific insulin, C-peptide, proinsulin, and free fatty acids at baseline and every 30 min after load for 2 h. Factor analysis was performed to evaluate the importance of insulin resistance and secretion abnormalities in both categories.RESULTS - All categories of prediabetic hyperglycemia had a higher cardiovascular risk factor level when adjusted for sex, age, and BMI compared to control subjects with normal glucose tolerance. Subjects with isolated IFG were more insulin resistant than those with IGT. By contrast, subjects with isolated IGT exhibited a more severe deficit in early- and late-phase insulin secretion versus IFG subjects. As shown with factor analysis, in IFG the insulin resistance factor explained 28.4% of the variance, whereas in IGT the insulin secretion factor was dominant, explaining 31.1% of the total variance.CONCLUSIONS - Our cross-sectional data from the RIAD study demonstrate that isolated IFG and isolated IGT are different with respect to the degree of insulin resistance and anomalies in insulin secretion, and that subjects with IGT exhibit a deficit in the early and late phases of insulin secretion. This finding may be important for a differential approach in primary prevention of type 2 diabetes.