Institute of Nutraceuticals and Functional Foods, Laval University, Québec, Québec, Canada.
Clin Endocrinol (Oxf). 2011 Mar;74(3):340-5. doi: 10.1111/j.1365-2265.2010.03933.x.
Women with impaired glucose tolerance (IGT) and type 2 diabetes (T2D) are more at risk of cardiovascular disease. The aim of this study was to test the hypothesis that increased visceral adipose tissue (VAT) could explain to a large extent alterations in the cardiovascular disease risk profile of postmenopausal women with IGT or T2D.
DESIGN, PATIENTS AND MEASUREMENTS: Sixty-two women with normal glucose tolerance (NGT), 33 with IGT and 18 with de novo diagnosed T2D were tested. The sample was further divided into five groups: (i) NGT-low VAT (<130 cm(2) ); (ii) NGT-high VAT (≥130 cm(2)); (iii) IGT-low VAT (<130 cm(2) ); (iv) IGT-high VAT (≥130 cm(2) ) and (v) T2D.
Women with T2D, women with IGT-high VAT and those with NGT-high VAT all had lower insulin sensitivity as determined by the euglycaemic-hyperinsulinaemic clamp (M_I), higher triglyceride (TG), lower HDL(2)-cholesterol (chol) levels and higher levels of high-sensitivity C-reactive protein than women with NGT-low VAT. Only differences in M_I and early insulin response (EIR) were observed between women with IGT-high VAT and those with NGT-high VAT (lower values in IGT-high VAT). Women with T2D had lower M_I and EIR as well as higher plasma TG and lower plasma Apo A1 and HDL-chol concentrations than women with NGT-high VAT.
Our results suggest that increase in VAT accumulation usually found in women with IGT explains to a large extent the deterioration in their plasma lipid-lipoprotein and inflammatory profile. However, factors other than VAT are involved in explaining the high TG-low HDL dyslipidaemia observed in women with T2D.
葡萄糖耐量受损（IGT）和 2 型糖尿病（T2D）女性发生心血管疾病的风险更高。本研究旨在验证下述假说，即内脏脂肪组织（VAT）的增加在很大程度上可以解释绝经后 IGT 或 T2D 女性心血管疾病风险特征的改变。
设计、患者和检测：共检测了 62 例糖耐量正常（NGT）、33 例 IGT 和 18 例新诊断 T2D 的女性。该样本进一步分为五组：（i）NGT-低 VAT（<130cm(2)）；（ii）NGT-高 VAT（≥130cm(2)）；（iii）IGT-低 VAT（<130cm(2)）；（iv）IGT-高 VAT（≥130cm(2)）和（v）T2D。
与 NGT-低 VAT 女性相比，T2D 女性、IGT-高 VAT 女性和 NGT-高 VAT 女性的胰岛素敏感性（通过正葡萄糖高胰岛素钳夹试验测定的 M_I）均更低，甘油三酯（TG）更高，高密度脂蛋白（HDL(2)-）胆固醇水平更低，高敏 C 反应蛋白水平更高。仅在 IGT-高 VAT 女性和 NGT-高 VAT 女性之间观察到 M_I 和早期胰岛素反应（EIR）的差异（IGT-高 VAT 女性的这些指标更低）。与 NGT-高 VAT 女性相比，T2D 女性的 M_I 和 EIR 更低，血浆 TG 更高，血浆载脂蛋白 A1 和 HDL 胆固醇浓度更低。
我们的结果表明，IGT 女性中通常观察到的 VAT 积累增加在很大程度上解释了其血浆脂质-脂蛋白和炎症特征的恶化。然而，除了 VAT 之外，其他因素也参与了解释 T2D 女性中存在的高 TG-低 HDL 血脂异常。
