Tokuyama Yoshiharu, Osawa Haruhiko, Ishizuka Toshiharu, Onuma Hiroshi, Matsui Kana, Egashira Toru, Makino Hideichi, Kanatsuka Azuma
Diabetes Center, Chiba Central Medical Center, Chiba, Japan.
Metabolism. 2007 May;56(5):693-8. doi: 10.1016/j.metabol.2006.12.019.
Impaired insulin secretion and decreased insulin sensitivity are the main pathophysiologic features responsible for development of hyperglycemia in type 2 diabetes mellitus. Insulin resistance is often associated with increased adipose tissue mass. To examine which variables influence insulin sensitivity, we compared metabolic parameters, serum resistin, leptin, and adiponectin concentrations to the insulin sensitivity, obtained by frequently sampled intravenous glucose tolerance test using the minimal model analysis, in 113 Japanese patients with type 2 diabetes mellitus. Duration of diabetes, fasting plasma glucose, fasting insulin, homeostasis model assessment of insulin resistance index, and serum resistin concentration were significantly higher in the insulin-resistant subgroup compared with the insulin-sensitive subgroup and correlated with insulin sensitivity. Stepwise regression analysis also identified these parameters as independent regulators of insulin sensitivity. The present study reconfirmed that fasting insulin level or homeostasis model assessment of insulin resistance would be a surrogate measure of insulin resistance and demonstrated that insulin resistance increases progressively after the onset of overt diabetes and that the serum resistin level is associated with insulin sensitivity, suggesting that resistin plays an important role in the development of insulin resistance in Japanese patients with type 2 diabetes mellitus.
胰岛素分泌受损和胰岛素敏感性降低是2型糖尿病发生高血糖的主要病理生理特征。胰岛素抵抗常与脂肪组织量增加相关。为了研究哪些变量影响胰岛素敏感性，我们在113例日本2型糖尿病患者中，将代谢参数、血清抵抗素、瘦素和脂联素浓度与通过使用最小模型分析的频繁采样静脉葡萄糖耐量试验获得的胰岛素敏感性进行了比较。与胰岛素敏感亚组相比，胰岛素抵抗亚组的糖尿病病程、空腹血糖、空腹胰岛素、胰岛素抵抗指数的稳态模型评估和血清抵抗素浓度显著更高，且与胰岛素敏感性相关。逐步回归分析也将这些参数确定为胰岛素敏感性的独立调节因子。本研究再次证实空腹胰岛素水平或胰岛素抵抗的稳态模型评估将是胰岛素抵抗的替代指标，并表明显性糖尿病发病后胰岛素抵抗逐渐增加，且血清抵抗素水平与胰岛素敏感性相关，提示抵抗素在日本2型糖尿病患者胰岛素抵抗的发生中起重要作用。
