Svec F, Nastasi K, Hilton C, Bao W, Srinivasan S R, Berenson G S
Section of Endocrinology, Louisiana State University Medical School, New Orleans 70112.
Diabetes. 1992 Mar;41(3):313-7. doi: 10.2337/diab.41.3.313.
Three hundred and seventy-seven children and adolescents aged 5-17 yr from the biracial (black-white) community of Bogalusa, Louisiana, were evaluated for Tanner stage of sexual development, plasma glucose, and insulin levels during an oral glucose tolerance test. Children of the two races were of similar age, weight, and height at each Tanner stage. Overall insulin response was compared by measuring the area under the insulin curve from the glucose tolerance test. Blacks, especially black females, had significantly higher insulin responses than their white counterparts. The insulin-glucose ratio at the initial t = 0 min baseline did not vary with race or sex throughout the Tanner stages. However, the 30 min postglucose data revealed clear differences between the races with blacks showing a higher insulin-glucose ratio. Ratios increased throughout puberty for both blacks and whites, boys and girls. The trends of racial contrasts seemed to be discernible even at the earliest stage of development. It is concluded that there is a clear difference between blacks and whites in insulin response to a glucose load early in childhood. These findings lead to the hypothesis that the greater prevalence of non-insulin-dependent diabetes mellitus seen in adult blacks, especially females, may be an expression of a difference in insulin secretion and related insulin resistance in early childhood.
对来自路易斯安那州博加卢萨黑白混血社区的377名5至17岁儿童和青少年进行了评估,以了解其性发育的坦纳分期、口服葡萄糖耐量试验期间的血浆葡萄糖和胰岛素水平。在每个坦纳分期,两个种族的儿童年龄、体重和身高相似。通过测量葡萄糖耐量试验胰岛素曲线下的面积来比较总体胰岛素反应。黑人,尤其是黑人女性,其胰岛素反应明显高于白人。在整个坦纳分期中,初始t = 0分钟基线时的胰岛素-葡萄糖比值不随种族或性别而变化。然而,葡萄糖摄入后30分钟的数据显示出种族之间的明显差异,黑人的胰岛素-葡萄糖比值更高。黑人和白人、男孩和女孩在青春期期间该比值均升高。即使在发育的最早阶段,种族差异趋势似乎也是明显的。结论是,儿童早期黑人与白人对葡萄糖负荷的胰岛素反应存在明显差异。这些发现提出了一个假设,即成年黑人尤其是女性中非胰岛素依赖型糖尿病的较高患病率可能是儿童早期胰岛素分泌差异及相关胰岛素抵抗的一种表现。