Rijkelijkhuizen Josina M, Doesburg Teddo, Girman Cynthia J, Mari Andrea, Rhodes Thomas, Gastaldelli Amalia, Nijpels Giel, Dekker Jacqueline M
EMGO Institute, VU University Medical Center, 1081 BT Amsterdam, The Netherlands.
Metabolism. 2009 Feb;58(2):196-203. doi: 10.1016/j.metabol.2008.09.013.
We evaluated the association of hepatic fat with beta-cell function estimated from the oral glucose tolerance test. In addition, we tested the hypothesis that postprandial free fatty acid (FFA) suppression after a meal tolerance test (MTT) is linked to hepatic fat. Individuals with normal glucose metabolism (NGM; n = 10 with low and n = 10 with high insulin secretion, matched for insulin sensitivity and sex), impaired glucose metabolism (IGM; n = 14), and type 2 diabetes mellitus (DM; n = 14) underwent a 75-g oral glucose tolerance test and MTT. beta-Cell function estimates were calculated from C-peptide using a mathematical model. Liver fat was quantified by proton magnetic resonance ((1)H-MR) spectroscopy. Area under the curve (AUC) of triglycerides (TG) and FFA responses during MTT represented postprandial lipid responses. Linear regression models were adjusted for age, sex, and additionally for insulin sensitivity for IGM/DM subjects. Liver fat content was equal for the NGM groups with low and high insulin secretion: 4.5% (2.6-6.0) (median, interquartile range) and 4.9% (2.3-7.8), respectively; liver fat percentages of IGM and diabetic subjects were significantly higher: 11.2 (6.7-21.1) and 10.0 (7.8-24.5). Liver fat showed a fairly strong, significant negative association with insulin sensitivity, but was not associated with beta-cell function. Significant associations of liver fat with fasting TG and AUC(TG) were shown in the total study population and in IGM/DM subjects separately. No relationship existed between fasting FFA or AUC(FFA) and liver fat. We conclude that fat accumulation in the liver is tightly linked to insulin sensitivity but not to beta-cell function. Furthermore, liver fat is associated with circulating TG levels, but not with FFA concentrations.
我们评估了肝脏脂肪与通过口服葡萄糖耐量试验估算的β细胞功能之间的关联。此外,我们检验了这样一个假设:餐后耐量试验(MTT)后餐后游离脂肪酸(FFA)的抑制与肝脏脂肪有关。葡萄糖代谢正常(NGM;胰岛素分泌低的10例和胰岛素分泌高的10例,根据胰岛素敏感性和性别匹配)、糖代谢受损(IGM;14例)和2型糖尿病(DM;14例)的个体接受了75克口服葡萄糖耐量试验和MTT。使用数学模型根据C肽计算β细胞功能估计值。通过质子磁共振((1)H-MR)波谱对肝脏脂肪进行定量。MTT期间甘油三酯(TG)和FFA反应的曲线下面积(AUC)代表餐后脂质反应。线性回归模型针对年龄、性别进行了校正,对于IGM/DM受试者还针对胰岛素敏感性进行了校正。胰岛素分泌低和高的NGM组肝脏脂肪含量相等:分别为4.5%(2.6 - 6.0)(中位数,四分位间距)和4.9%(2.3 - 7.8);IGM和糖尿病受试者的肝脏脂肪百分比显著更高:分别为11.2(6.7 - 21.1)和10.0(7.8 - 24.5)。肝脏脂肪与胰岛素敏感性呈相当强的显著负相关,但与β细胞功能无关。在整个研究人群以及分别在IGM/DM受试者中,肝脏脂肪与空腹TG和AUC(TG)存在显著关联。空腹FFA或AUC(FFA)与肝脏脂肪之间不存在关系。我们得出结论,肝脏中的脂肪堆积与胰岛素敏感性紧密相关,但与β细胞功能无关。此外,肝脏脂肪与循环TG水平相关,但与FFA浓度无关。