Thamer C, Haap M, Heller E, Joel L, Braun S, Tschritter O, Haring H, Fritsche A
Department of Endocrinology and Metabolism, Eberhard-Karls-University, Tübingen, Germany.
Horm Metab Res. 2006 Mar;38(3):178-82. doi: 10.1055/s-2006-925204.
Insulin resistance, impaired insulin secretion, and low adiponectin levels have been shown to be predictors for type 2 diabetes. However, it is not yet clear whether these associations (1) are independent of changes in body weight, or (2) are valid for changes in glucose tolerance in the prediabetic state. Sixty-two non-diabetics (50 with normal glucose tolerance) aged 41 +/- 11 years, BMI 30.5 +/- 5.3 kg/m2 (mean +/- SD) were studied twice with a standard oral glucose tolerance test (oGTT, mean follow-up time 3.0 +/- 1.8 years (mean +/- SD) [range 0.5-6.5 years]). Insulin sensitivity and insulin secretion were estimated from oGTT using validated indices. Two-hour blood glucose during oGTT deteriorated over time (baseline 2 h glucose 6.32 +/- 0.21 VS. follow-up 2 h glucose 7.14 +/- 0.22 mM, p < 0.001) while the percentage body fat did not change (32.7 +/- 1.2 VS. 32.6 +/- 1.2%, p = 0.46). Follow-up 2 h blood glucose was predicted by adiponectin (p = 0.01), baseline insulin sensitivity (p = 0.02) and baseline insulin secretion relative to insulin sensitivity (p = 0.03) independent of sex, age, baseline 2 h blood glucose or change in percentage body fat. Our results suggest that low adiponectin levels, insulin resistance and low beta cell function predict the continuous deterioration of glucose tolerance in early prediabetic states, independent of changes in adiposity. Therefore, the early influence of these parameters should be the subject of future prevention programs to prevent deterioration of glucose tolerance.
胰岛素抵抗、胰岛素分泌受损和脂联素水平降低已被证明是2型糖尿病的预测指标。然而，目前尚不清楚这些关联：（1）是否独立于体重变化；（2）对于糖尿病前期状态下糖耐量的变化是否有效。对62名年龄为41±11岁、BMI为30.5±5.3kg/m²（均值±标准差）的非糖尿病患者（50名糖耐量正常）进行了两次标准口服葡萄糖耐量试验（oGTT，平均随访时间3.0±1.8年（均值±标准差）[范围0.5 - 6.5年]）。使用经过验证的指标从oGTT中估算胰岛素敏感性和胰岛素分泌。oGTT期间的两小时血糖随时间恶化（基线2小时血糖6.32±0.21与随访2小时血糖7.14±0.22mM，p<0.001），而体脂百分比未变化（32.7±1.2与32.6±1.2%，p = 0.46）。随访2小时血糖由脂联素（p = 0.01）、基线胰岛素敏感性（p = 0.02）和相对于胰岛素敏感性的基线胰岛素分泌（p = 0.03）预测，独立于性别、年龄、基线2小时血糖或体脂百分比变化。我们的结果表明，低脂联素水平、胰岛素抵抗和低β细胞功能可预测糖尿病前期早期糖耐量的持续恶化，独立于肥胖的变化。因此，这些参数的早期影响应成为未来预防糖耐量恶化的预防计划的主题。
