Goran Michael I, Bergman Richard N, Cruz Martha L, Watanabe Richard
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles 90033, USA.
Diabetes Care. 2002 Dec;25(12):2184-90. doi: 10.2337/diacare.25.12.2184.
The objective of this study was to compare insulin resistance relative to body fat and the associated compensatory responses in 57 healthy children living in Los Angeles, California (14 Caucasians, 15 African-Americans, and 28 Hispanics).
Insulin sensitivity and acute insulin response were determined by intravenous glucose tolerance test. Insulin secretion, hepatic insulin extraction, and insulin clearance were estimated by C-peptide and insulin modeling.
Insulin sensitivity was significantly lower in Hispanics and African-Americans compared with Caucasian children, and acute insulin response was significantly higher in African-American children. No ethnic differences were noted in the first-phase secretion, but second-phase insulin secretion was significantly higher in Hispanic children than in African-American children (200 +/- 53 vs. 289 +/- 41 nmol/min; P = 0.03). The greater acute insulin response in African-Americans, despite lower secretion, was explained by a lower hepatic insulin extraction in African-Americans compared with Hispanics (36.6 +/- 2.9 vs. 47.3 +/- 2.2%; P = 0.0006).
In conclusion, Hispanic and African-American children are more insulin resistant than Caucasian children, but the associated compensatory responses are different across ethnic groups.
本研究的目的是比较加利福尼亚州洛杉矶市57名健康儿童(14名高加索人、15名非裔美国人、28名西班牙裔)相对于体脂的胰岛素抵抗及相关代偿反应。
通过静脉葡萄糖耐量试验测定胰岛素敏感性和急性胰岛素反应。通过C肽和胰岛素模型评估胰岛素分泌、肝脏胰岛素摄取和胰岛素清除率。
与高加索儿童相比,西班牙裔和非裔美国儿童的胰岛素敏感性显著降低,非裔美国儿童的急性胰岛素反应显著升高。在第一阶段分泌方面未观察到种族差异,但西班牙裔儿童的第二阶段胰岛素分泌显著高于非裔美国儿童(200±53对289±41nmol/分钟;P=0.03)。尽管非裔美国人的分泌较低,但其急性胰岛素反应较高,这是由于与西班牙裔相比,非裔美国人的肝脏胰岛素摄取较低(36.6±2.9对47.3±2.2%;P=0.0006)。
总之,西班牙裔和非裔美国儿童比高加索儿童更具胰岛素抵抗性,但不同种族的相关代偿反应有所不同。