Hasson R E, Adam T C, Davis J N, Watanabe R M, Goran M I
School of Kinesiology and Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Pediatr Obes. 2013 Dec;8(6):e68-73. doi: 10.1111/j.2047-6310.2013.00184.x. Epub 2013 Jul 2.
Insulin responses to oral and intravenous glucose markedly differ by ethnicity. This study examined whether ethnic differences in pancreatic insulin secretion, hepatic insulin extraction and clearance explain these disparate findings in 35 obese African-American and 41 Latina girls (Tanner Stages: IV-V; ages: 14-18; body mass index percentile: 85.9-99.8%).
Pancreatic insulin secretion, hepatic insulin extraction and clearance were estimated by C-peptide and insulin modeling during an oral glucose tolerance test. Insulin sensitivity (SI), acute insulin response to glucose (AIRG ) and disposition index were derived from a frequently sampled intravenous glucose tolerance test.
Compared to Latinas, obese African-American adolescents had lower pancreatic insulin secretion (21.3%; P < 0.01), glucose incremental area under the curve (IAUC) (41.7%, P = 0.02), C-peptide IAUC (25.1%, P < 0.01) and SI (33.7%; P < 0.01). There were no ethnic differences in hepatic insulin extraction and clearance (P's > 0.05).
Compensatory mechanisms to insulin resistance do not appear to explain the ethnic differences in insulin responses to oral and intravenous glucose in obese African-American and Latina girls.
胰岛素对口服和静脉注射葡萄糖的反应因种族不同而有显著差异。本研究调查了35名肥胖非裔美国女孩和41名拉丁裔女孩（ Tanner分期：IV - V期；年龄：14 - 18岁；体重指数百分位数：85.9 - 99.8%）在胰腺胰岛素分泌、肝脏胰岛素提取和清除方面的种族差异是否能解释这些不同的结果。
在口服葡萄糖耐量试验期间，通过C肽和胰岛素模型评估胰腺胰岛素分泌、肝脏胰岛素提取和清除情况。胰岛素敏感性（SI）、对葡萄糖的急性胰岛素反应（AIRG）和处置指数来自频繁采样的静脉葡萄糖耐量试验。
与拉丁裔相比，肥胖非裔美国青少年的胰腺胰岛素分泌较低（21.3%；P < 0.01）、葡萄糖曲线下增量面积（IAUC）较低（41.7%，P = 0.02）、C肽IAUC较低（25.1%，P < 0.01）以及SI较低（33.7%；P < 0.01）。肝脏胰岛素提取和清除方面不存在种族差异（P > 0.05）。
胰岛素抵抗的代偿机制似乎无法解释肥胖非裔美国女孩和拉丁裔女孩在胰岛素对口服和静脉注射葡萄糖反应上的种族差异。
