Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Diabet Med. 2012 Nov;29(11):1407-11. doi: 10.1111/j.1464-5491.2012.03728.x.
To quantify and compare associations between femoral-gluteal adiposity and insulin sensitivity in adults with Type 1 diabetes mellitus with adults with normal glucose tolerance.
Individuals with Type 1 diabetes (n = 28) were recruited from the Pittsburgh Epidemiology of Diabetes Complication study, a 24-year prospective study of childhood-onset diabetes, and compared cross-sectionally with individuals with normal glucose tolerance (n = 56) of similar age, sex and BMI. Insulin sensitivity was defined as whole-body glucose disposal measured by hyperinsulinaemic-euglycaemic clamps. Adiposity was quantified by dual energy X-ray absorptiometry.
Individuals with Type 1 diabetes exhibited lower insulin sensitivity (5.8 vs. 8.2 mg min(-1) kg fat-free mass(-1), P < 0.01), lower total fat mass (20.1 vs. 29.0 kg, P < 0.001) and lower proportional leg fat mass (36.0 vs.37.7%, P = 0.03), but similar proportional trunk fat (% trunk fat mass) compared with individuals with normal glucose tolerance. Overall, results from linear regression demonstrated that higher % leg fat mass (P < 0.01) and lower % trunk fat mass (P < 0.01) were independently associated with lower insulin sensitivity after adjustments for age, sex, height, total fat mass (kg) and diabetes status. Higher % leg fat mass was independently associated with higher insulin sensitivity in individuals with normal glucose tolerance (P < 0.01) after similar adjustment; significant associations were not observed in Type 1 diabetes.
Reduced insulin sensitivity is a prominent feature of Type 1 diabetes and is associated with total and abdominal adiposity. Compared with adults with normal glucose tolerance, leg fat mass does not show any positive association with insulin sensitivity in Type 1 diabetes.
定量比较和比较 1 型糖尿病成人与糖耐量正常成人股臀脂肪与胰岛素敏感性的关系。
从匹兹堡糖尿病并发症流行病学研究中招募了 28 名 1 型糖尿病患者（n = 28），这是一项针对儿童发病的 24 年前瞻性研究，并与年龄、性别和 BMI 相似的 56 名糖耐量正常个体进行了横断面比较。胰岛素敏感性定义为通过高胰岛素正葡萄糖钳夹测量的全身葡萄糖处置。通过双能 X 射线吸收法定量测量脂肪量。
1 型糖尿病患者的胰岛素敏感性较低（5.8 对 8.2mg min(-1) kg 去脂体重(-1)，P < 0.01），总脂肪量较低（20.1 对 29.0kg，P < 0.001）和较低的腿部脂肪比例（36.0 对 37.7%，P = 0.03），但与糖耐量正常个体的比例躯干脂肪相似（%躯干脂肪量）。总体而言，线性回归结果表明，在调整年龄、性别、身高、总脂肪量（kg）和糖尿病状态后，较高的%腿部脂肪量（P < 0.01）和较低的%躯干脂肪量（P < 0.01）与较低的胰岛素敏感性独立相关。在调整相似的因素后，较高的%腿部脂肪量与糖耐量正常个体的胰岛素敏感性呈独立正相关（P < 0.01）；在 1 型糖尿病中未观察到显著关联。
胰岛素敏感性降低是 1 型糖尿病的一个突出特征，与总脂肪和腹部脂肪有关。与糖耐量正常的成年人相比，腿部脂肪量与 1 型糖尿病患者的胰岛素敏感性没有任何正相关关系。
