Deivanayagam Sheela, Mohammed B Selma, Vitola Bernadette E, Naguib Gihan H, Keshen Tamir H, Kirk Erik P, Klein Samuel
Division of Geriatrics and Nutritional Science and Center for Human Nutrition and the Division of Pediatric Surgery, Washington University, School of Medicine, St Louis, MO, USA.
Am J Clin Nutr. 2008 Aug;88(2):257-62. doi: 10.1093/ajcn/88.2.257.
Nonalcoholic fatty liver disease (NAFLD) and insulin resistance are common in overweight adolescents.
The purpose of this study was to determine the relation between NAFLD and insulin sensitivity in liver and skeletal muscle by studying overweight adolescents with a normal or high intrahepatic triglyceride (IHTG) content, who were matched for age, sex, body mass index (BMI; in kg/m(2)), and Tanner stage.
Stable-isotope-labeled tracer infusion and the hyperinsulinemic-euglycemic clamp procedure were used to assess skeletal muscle and hepatic insulin sensitivity, and magnetic resonance spectroscopy was used to assess the IHTG content in 10 overweight (BMI = 35.9 +/- 1.3) adolescents with NAFLD (IHTG = 28.4 +/- 3.4%) and 10 overweight (BMI = 36.6 +/- 1.5) adolescents with a normal IHTG content (3.3 +/- 0.5%).
The baseline plasma glucose concentration and the rate of appearance of glucose in plasma were the same in subjects with a normal (87.1 +/- 1.2 mg/dL, 16.2 +/- 1.1 micromol . kg fat-free mass(-1) . min(-1)) or high (89.2 +/- 2.5 mg/dL, 16.3 +/- 1.2 micromol . kg fat-free mass(-1) . min(-1)) IHTG content. However, compared with subjects who had a normal IHTG content, subjects with NAFLD had a lower hepatic insulin sensitivity index, based on baseline glucose kinetics and insulin concentrations (4.0 +/- 0.5 compared with 2.4 +/- 0.4; P < 0.05) and an impaired increase in glucose uptake during insulin infusion (169 +/- 28.1% compared with 67 +/- 9.6% above baseline; P < 0.01). In addition, the plasma triglyceride concentration was greater and the plasma HDL-cholesterol concentration was lower in subjects with NAFLD than in those with a normal IHTG content.
An elevated IHTG content in overweight adolescents is associated with dyslipidemia and with insulin-resistant glucose metabolism in both liver and skeletal muscle.
非酒精性脂肪性肝病（NAFLD）和胰岛素抵抗在超重青少年中很常见。
本研究的目的是通过研究肝内甘油三酯（IHTG）含量正常或较高、年龄、性别、体重指数（BMI；单位：kg/m²）和 Tanner 分期相匹配的超重青少年，来确定 NAFLD 与肝脏和骨骼肌胰岛素敏感性之间的关系。
采用稳定同位素标记示踪剂输注和高胰岛素-正葡萄糖钳夹技术评估骨骼肌和肝脏胰岛素敏感性，并用磁共振波谱法评估 10 名患有 NAFLD（IHTG = 28.4 ± 3.4%）的超重青少年（BMI = 35.9 ± 1.3）和 10 名 IHTG 含量正常（3.3 ± 0.5%）的超重青少年（BMI = 36.6 ± 1.5）的 IHTG 含量。
IHTG 含量正常（87.1 ± 1.2 mg/dL，16.2 ± 1.1 μmol·kg 去脂体重⁻¹·min⁻¹）或较高（89.2 ± 2.5 mg/dL，16.3 ± 1.2 μmol·kg 去脂体重⁻¹·min⁻¹）的受试者的基线血浆葡萄糖浓度和血浆葡萄糖出现率相同。然而，与 IHTG 含量正常的受试者相比，患有 NAFLD 的受试者基于基线葡萄糖动力学和胰岛素浓度的肝脏胰岛素敏感性指数较低（分别为 4.0 ± 0.5 和 2.4 ± 0.4；P < 0.05），且胰岛素输注期间葡萄糖摄取的增加受损（分别比基线高 169 ± 28.1%和 67 ± 9.6%；P < 0.01）。此外，患有 NAFLD 的受试者的血浆甘油三酯浓度较高，血浆高密度脂蛋白胆固醇浓度较低。
超重青少年中 IHTG 含量升高与血脂异常以及肝脏和骨骼肌中胰岛素抵抗性葡萄糖代谢有关。
