Rhee Sang Youl, Kwon Mi Kwang, Park Byong-Jo, Chon Suk, Jeong In-Kyung, Oh Seungjoon, Ahn Kyu Jeung, Chung Ho Yeon, Kim Sung Woon, Kim Jin-Woo, Kim Young Seol, Woo Jeong-Taek
Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
Korean J Intern Med. 2007 Dec;22(4):270-4. doi: 10.3904/kjim.2007.22.4.270.
This study examined whether defects in insulin secretion contribute to the development and progression of type 2 diabetes mellitus (T2DM).
Plasma insulin and glucose were measured after a glucose tolerance test to calculate the insulinogenic index (IGI) and the HOMA-IR Homeostasis model assessment of insulin resistance in subjects with normal glucose tolerance (NGT), prediabetes (preDM, n = 49), and T2DM patients with disease duration < 1 year (n = 84), 1 approximately 5 years (n = 45), or > 5 years (n = 37). Plasma proinsulin and adiponectin levels were also measured as a parameter of insulin secretion and resistance.
The mean HOMA-IR increased and the adiponectin levels decreased relative to the deterioration of glucose tolerance in NGT and preDM subjects. However, differences in the HOMA-IR were not related to disease duration in T2DM subjects. The mean IGI was similar in NGT and preDM subjects, but there were significant deteriorations in IGI relative to the duration of diabetes.
Defects in both insulin sensitivity and insulin secretion contribute to T2DM, but decreased insulin secretion may be more important in the development and progression of T2DM.
本研究探讨胰岛素分泌缺陷是否会导致2型糖尿病（T2DM）的发生和发展。
对糖耐量正常（NGT）、糖尿病前期（preDM，n = 49）以及病程<1年（n = 84）、1至5年（n = 45）或>5年（n = 37）的T2DM患者进行葡萄糖耐量试验后，测量血浆胰岛素和葡萄糖水平，以计算胰岛素生成指数（IGI）和胰岛素抵抗的稳态模型评估（HOMA-IR）。还测量了血浆胰岛素原和脂联素水平，作为胰岛素分泌和抵抗的参数。
相对于NGT和preDM受试者糖耐量的恶化，平均HOMA-IR升高，脂联素水平降低。然而，T2DM受试者中HOMA-IR的差异与病程无关。NGT和preDM受试者的平均IGI相似，但相对于糖尿病病程，IGI有显著恶化。
胰岛素敏感性和胰岛素分泌缺陷均导致T2DM，但胰岛素分泌减少在T2DM的发生和发展中可能更为重要。
