糖尿病患者口服葡萄糖耐量试验期间骨骼肌中的间质葡萄糖。

Interstitial glucose in skeletal muscle of diabetic patients during an oral glucose tolerance test.

作者信息

Frossard M, Blank D, Joukhadar Ch, Bayegan K, Schmid R, Luger A, Müller M

机构信息

Department of Clinical Pharmacology, Division of Clinical Pharmacokinetics, University of Vienna Medical School, A-1090 Vienna, Austria.

出版信息

Diabet Med. 2005 Jan;22(1):56-60. doi: 10.1111/j.1464-5491.2004.01360.x.

DOI:10.1111/j.1464-5491.2004.01360.x

PMID:15606692

Abstract

AIM

The presence of a transcapillary arterial-interstitial gradient for glucose (AIG(glu)) in skeletal muscle may be interpreted as a consequence of intact cellular glucose uptake. We hypothesized that the AIG(glu) decreases in Type 2 diabetes mellitus as a consequence of insulin resistance, whereas it remains intact in Type 1 diabetes.

METHODS

Glucose concentrations were measured in serum and interstitial space fluid of skeletal muscle during an oral glucose tolerance test (OGTT) in patients with Type 1 and Type 2 diabetes and in young and middle-aged healthy volunteers, using microdialysis.

RESULTS

The area under the curve for glucose in serum (AUC(SE)) was higher than in interstitial space fluid of skeletal muscle (AUC(MU)) in healthy young (AUC(SE) = 1147 +/- 332 vs. AUC(MU) = 633 +/- 257 mM/min/ml; P = 0.006), healthy middle-aged volunteers (AUC(SE) = 1406 +/- 186 vs. AUC(MU) = 1048 +/- 229 mM/min/ml; P = 0.001) and in Type 1 diabetic patients (AUC(SE) = 2273 +/- 486 vs. AUC(MU) = 1655 +/- 178 mM/min/ml; P = 0.003). In contrast, in Type 2 diabetic patients AUC(SE) (2908 +/- 1023 mM/min/ml) was not significantly different from AUC(MU) (2610 +/- 722 mM/min/ml; P = NS).

CONCLUSION

The present data indicate that AIG(glu) is compromised in Type 2 diabetes in contrast to Type 1 diabetes where it appears to be normal. Because no changes in muscle blood flow were detected, insulin resistance appears to be the main cause for the observed decreased AIG(glu) in skeletal muscle in Type 2 diabetic patients.

摘要

目的

骨骼肌中存在葡萄糖的跨毛细血管动脉-组织间隙梯度（AIG(glu)）可被解释为细胞葡萄糖摄取完整的结果。我们假设2型糖尿病中AIG(glu)降低是胰岛素抵抗的结果，而在1型糖尿病中其保持完整。

方法

在1型和2型糖尿病患者以及年轻和中年健康志愿者进行口服葡萄糖耐量试验（OGTT）期间，使用微透析法测量骨骼肌血清和组织间隙液中的葡萄糖浓度。

结果

健康年轻志愿者（血清葡萄糖曲线下面积（AUC(SE)）= 1147±332 vs. 骨骼肌组织间隙液葡萄糖曲线下面积（AUC(MU)）= 633±257 mM/min/ml；P = 0.006）、健康中年志愿者（AUC(SE) = 1406±186 vs. AUC(MU) = 1048±229 mM/min/ml；P = 0.001）和1型糖尿病患者（AUC(SE) = 2273±486 vs. AUC(MU) = 1655±178 mM/min/ml；P = 0.003）血清中的AUC(SE)高于骨骼肌组织间隙液中的AUC(MU)。相比之下，2型糖尿病患者的AUC(SE)（2908±1023 mM/min/ml）与AUC(MU)（2610±722 mM/min/ml；P =无显著性差异）无显著差异。