Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita 565-0871, Japan.
Endocr J. 2013;60(7):923-30. doi: 10.1507/endocrj.ej13-0046. Epub 2013 Mar 16.
The aim of the current study was to investigate whether obese subjects have different insulin secretory capacity compared to lean subjects with the same glucose tolerance in a Japanese population. We included a total of 1749 Japanese employees who underwent 75-g oral glucose tolerance test (OGTT). The study population was divided into deciles of 120-min glucose levels and the indices of insulin secretion and insulin sensitivity in each decile were compared between the subjects with and without obesity (body mass index ≥ 25 kg/m2). The indices used in the current study were Matsuda index, insulinogenic index, and disposition index. Obese subjects had significantly lower values of Matsuda index and significantly higher value of insulinogenic index than non-obese subjects in every decile (all p < 0.05). On the other hand, disposition index was not significantly different between non-obese and obese subjects in any decile of 120-min glucose level (all p > 0.05). Similar findings were observed when the study population was classified by waist circumference. In conclusion, disposition index derived from the data of 75-g OGTT was similarly decreased in obese Japanese subjects compared to non-obese Japanese subjects with the same post-load glucose levels. Future studies will be needed to confirm whether the development of glucose intolerance in obese Japanese subjects is accompanied by the same degree of pancreatic beta cell dysfunction as non-obese Japanese subjects.
本研究旨在探讨在日本人群中,与葡萄糖耐量相同的瘦人相比,肥胖者的胰岛素分泌能力是否存在差异。我们共纳入了 1749 名接受 75g 口服葡萄糖耐量试验(OGTT)的日本员工。将研究人群按 120 分钟血糖水平的十分位数进行分组,并比较肥胖(体重指数≥25kg/m2)和非肥胖患者各分位数的胰岛素分泌和胰岛素敏感性指标。本研究中使用的指标包括 Matsuda 指数、胰岛素生成指数和处置指数。在每个十分位数中,肥胖患者的 Matsuda 指数均显著低于非肥胖患者,而胰岛素生成指数显著高于非肥胖患者(均 P<0.05)。另一方面,在任何一个 120 分钟血糖水平的十分位数中,非肥胖和肥胖患者的处置指数均无显著差异(均 P>0.05)。当根据腰围对研究人群进行分类时,也观察到了类似的发现。总之,与葡萄糖耐量相同的非肥胖日本患者相比,75g OGTT 数据得出的处置指数在肥胖日本患者中也明显降低。未来的研究将需要证实肥胖日本患者的葡萄糖耐量受损是否伴有与非肥胖日本患者相同程度的胰岛β细胞功能障碍。