National Institute of Diseases of Chest and Hospital (NIDCH), Dept of Biochemistry, Dhaka, Bangladesh.
Metab Syndr Relat Disord. 2007 Sep;5(3):275-81. doi: 10.1089/met.2006.0030.
The relative contribution of insulin secretion and sensitivity in the development of type 2 diabetes mellitus (T2DM) vary from population to population due to the heterogeneous nature of the disease. The study was undertaken to evaluate the insulin secretory capacity and sensitivity in a Bangladeshi type 2 diabetic population and to explore the association of some of the anthropometric (BMI, WHR, MBP) and biochemical factors (glucose, lipids, HbA(1c)) known to modulate B-cell function and insulin action.
Ninety three T2DM and 70 age-matched control subjects were studied for their fasting glucose, lipids, HbA(1c) (by HPLC) and C-peptide (by ELISA). Insulin secretion (HOMA B) and insulin sensitivity (HOMA S) were calculated by homeostasis model assessment (HOMA).
Both insulin secretion and sensitivity were significantly reduced in diabetic as compared to control subjects (HOMA B%, geometric M +/- SD, 34.67 +/- 1.73 vs 104.71 +/- 1.34, p < 0.001; HOMA S%, 67.60 +/- 1.69 vs 85.11 +/- 1.54, p < 0.01). However, the discriminant function coefficient for HOMA B (1.142) was about 1.5 times higher than that for HOMA S (0.731). In T2DM, HOMA B had positive correlation with BMI (r = 0.362, p < 0.001) and inverse correlation with plasma glucose (r = - 0.701, p < 0.001) and HbA1c (r = - 0.612, p < 0.001). HOMA S was inversely correlated to BMI (r = - 0.274, p < 0.01), WHR (r = - 0.252, p < 0.05), plasma total cholesterol (r = - 0.240, p < 0.05) and triglycerides (r = 0.301, p < 0.01).
Both insulin secretory dysfunction and insulin resistance are present in Bangladeshi T2DM subjects, but B-cell dysfunction seems to be the predominant defect. BMI, plasma glucose and insulin are the major determinants of insulin secretory capacity; and generalized as well as central obesity, plasma glucose, total cholesterol, triglycerides and insulin are among the major determinants of insulin sensitivity in this population.
由于 2 型糖尿病（T2DM）的异质性，胰岛素分泌和敏感性在不同人群中的相对贡献因人群而异。本研究旨在评估孟加拉国 2 型糖尿病患者的胰岛素分泌能力和敏感性，并探讨一些已知调节β细胞功能和胰岛素作用的人体测量学（BMI、WHR、MBP）和生化因素（血糖、血脂、HbA（1c））与胰岛素分泌和敏感性的相关性。
研究了 93 名 T2DM 患者和 70 名年龄匹配的对照组的空腹血糖、血脂、HbA（1c）（通过 HPLC）和 C-肽（通过 ELISA）。通过稳态模型评估（HOMA）计算胰岛素分泌（HOMA B）和胰岛素敏感性（HOMA S）。
与对照组相比，糖尿病患者的胰岛素分泌和敏感性均显著降低（HOMA B%，几何均数 +/- 标准差，34.67 +/- 1.73 与 104.71 +/- 1.34，p < 0.001；HOMA S%，67.60 +/- 1.69 与 85.11 +/- 1.54，p < 0.01）。然而，HOMA B 的判别函数系数（1.142）约为 HOMA S（0.731）的 1.5 倍。在 T2DM 中，HOMA B 与 BMI 呈正相关（r = 0.362，p < 0.001），与血浆葡萄糖（r = -0.701，p < 0.001）和 HbA1c（r = -0.612，p < 0.001）呈负相关。HOMA S 与 BMI（r = -0.274，p < 0.01）、WHR（r = -0.252，p < 0.05）、血浆总胆固醇（r = -0.240，p < 0.05）和甘油三酯（r = 0.301，p < 0.01）呈负相关。
孟加拉国 T2DM 患者存在胰岛素分泌功能障碍和胰岛素抵抗，但β细胞功能障碍似乎是主要缺陷。BMI、血浆葡萄糖和胰岛素是胰岛素分泌能力的主要决定因素；而在该人群中，全身性和中心性肥胖、血浆葡萄糖、总胆固醇、甘油三酯和胰岛素是胰岛素敏感性的主要决定因素。
