Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
Obesity (Silver Spring). 2012 Oct;20(10):1966-73. doi: 10.1038/oby.2011.384. Epub 2012 Jan 26.
The impact of sex and age on glucose metabolism in the development of overweight/obesity is a matter of debate. We hypothesized that insulin sensitivity (IS) and β-cell function (BF) in a normal white population will differ between males and females and aimed to evaluate the possible effects of BMI and age on metabolic parameters of both sexes. This study is a cross-sectional analysis of the general community. IS was measured with quantitative insulin sensitivity check index (QUICKI) and oral glucose insulin sensitivity (OGIS) and BF with the insulinogenic index during 75-g 2-h oral glucose-tolerance tests (OGTTs). We studied 611 females and 361 males with normal glycemia according to both fasting and 2-h glucose (85 ± 0.3 mg/dl (means ± SE) in females and 89 ± 0.4 in males (P < 0.0001), and 93 ± 1 in females and 89 ± 1 in males (P = 0.005), respectively). Females were younger (37 ± 1 years) than males (40 ± 1, P < 0.0001), but no difference was found in mean BMI (BMI = 25.8 ± 0.2 kg/m(2) in both). Student's two-sample t-test was used for simple comparison between and within genders, multiple linear regressions to account for covariates. During the OGTT, females had lower glucose (area under the curve (AUC) 133 ± 1 mg/ml·2 h vs. 148 ± 2; P < 0.00001), while insulinemia was comparable (AUC 5.3 ± 0.1 mU/ml·2 h vs. 5.7 ± 0.2, P = 0.15). IS remained higher in females (473 ± 3 ml/min/m(2) vs. 454 ± 3, P < 0.0001) also after having accounted for age and BMI (P = 0.015). No difference was observed in fasting insulin or BF. However, BF increased by 46% with BMI and when accounting for age and BMI, BF of females was significantly higher (P < 0.0001). Because IS and BF are higher in females than in males, sex should be considered in metabolic studies and overweight/obese populations.
性别和年龄对超重/肥胖者葡萄糖代谢的影响一直存在争议。我们假设在正常白种人群中，男性和女性的胰岛素敏感性（IS）和β细胞功能（BF）存在差异，并旨在评估 BMI 和年龄对两性代谢参数的可能影响。本研究是对普通人群进行的横断面分析。采用定量胰岛素敏感性检查指数（QUICKI）和口服葡萄糖胰岛素敏感性（OGIS）检测 IS，采用 75g 2 小时口服糖耐量试验（OGTT）期间的胰岛素原指数检测 BF。我们研究了 611 名女性和 361 名男性，他们的空腹和 2 小时血糖均正常（女性 85±0.3mg/dl（平均值±SE），男性 89±0.4mg/dl（P<0.0001），女性 93±1mg/dl，男性 89±1mg/dl（P=0.005）。女性（37±1 岁）比男性（40±1 岁）年轻（P<0.0001），但平均 BMI 无差异（女性 25.8±0.2kg/m2，男性 25.8±0.2kg/m2）。t 检验用于简单比较男女之间和内部的差异，多元线性回归用于校正协变量。在 OGTT 期间，女性的血糖（AUC 133±1mg/ml·2h vs. 148±2mg/ml·2h；P<0.00001）较低，而胰岛素血症相似（AUC 5.3±0.1mU/ml·2h vs. 5.7±0.2mU/ml·2h；P=0.15）。校正年龄和 BMI 后，女性的 IS 仍较高（473±3ml/min/m2 vs. 454±3ml/min/m2；P<0.0001）。空腹胰岛素或 BF 无差异。然而，BF 随 BMI 增加 46%，校正年龄和 BMI 后，女性的 BF 明显更高（P<0.0001）。由于 IS 和 BF 在女性中高于男性，因此在代谢研究和超重/肥胖人群中应考虑性别因素。
