Karpe Fredrik, Fielding Barbara A, Ilic Vera, Macdonald Ian A, Summers Lucinda K M, Frayn Keith N
Oxford Lipid Metabolism Group, Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Infirmary, Oxford, UK.
Diabetes. 2002 Aug;51(8):2467-73. doi: 10.2337/diabetes.51.8.2467.
Obesity has been associated with dysfunctional postprandial adipose tissue blood flow (ATBF), but it has also been recognized that the interindividual response is highly variable. The present work aimed at characterizing this variability. Fifteen subjects were given 75 g oral glucose, and abdominal subcutaneous ATBF was monitored by the (133)Xe washout method. Determinants of insulin sensitivity based on nonesterified fatty acid (NEFA) suppression after oral glucose administration [ISI(NEFA)] were higher in the top tertile ATBF response group (1.29 +/- 0.09 vs. 0.90 +/- 0.08 in the lower tertiles, P = 0.01). ISI(NEFA) was related to ATBF response (r(s) = 0.73, P < 0.002) as well as insulin sensitivity based on postprandial glycemia [ISI(gly), r(s) = 0.58, P < 0.05], whereas the homeostasis model assessment (HOMA) index (r(s) = -0.39, P = 0.16) was not. The relationship between increase in ATBF and ISI(NEFA) was independent of BMI (P = 0.015) in multivariate analysis. Subjects with a high ATBF response had significantly higher increase of plasma norepinephrine (P < 0.05), indicating a link between postprandial insulinemia, sympathetic activation, and ATBF response. There is a close relationship between insulin sensitivity and the regulation of postprandial ATBF, independent of adiposity. Impaired regulation of ATBF seems to be another facet of the insulin resistance syndrome.
肥胖与餐后脂肪组织血流量（ATBF）功能失调有关，但个体间的反应差异很大也已得到公认。本研究旨在描述这种变异性。15名受试者口服75克葡萄糖，采用（133）Xe洗脱法监测腹部皮下ATBF。口服葡萄糖后基于非酯化脂肪酸（NEFA）抑制的胰岛素敏感性决定因素[ISI（NEFA）]在ATBF反应最高三分位组中更高（分别为1.29±0.09和较低三分位组中的0.90±0.08，P = 0.01）。ISI（NEFA）与ATBF反应相关（r（s）= 0.73，P < 0.002），也与基于餐后血糖的胰岛素敏感性[ISI（血糖），r（s）= 0.58，P < 0.05]相关，而稳态模型评估（HOMA）指数（r（s）= -0.39，P = 0.16）则不然。多因素分析显示，ATBF增加与ISI（NEFA）之间的关系独立于BMI（P = 0.015）。ATBF反应高的受试者血浆去甲肾上腺素显著升高（P < 0.05），表明餐后胰岛素血症、交感神经激活与ATBF反应之间存在联系。胰岛素敏感性与餐后ATBF调节之间存在密切关系，与肥胖无关。ATBF调节受损似乎是胰岛素抵抗综合征的另一个方面。
