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在葡萄糖耐量异常的受试者中,去脂体重与口服葡萄糖负荷后的血浆葡萄糖水平呈负相关,且独立于胰岛素分泌或胰岛素敏感性。

Lean mass inversely predicts plasma glucose levels after oral glucose load independent of insulin secretion or insulin sensitivity in glucose intolerance subjects.

作者信息

Kwankaew Jirateep, Saetung Sunee, Chanprasertyothin Suwannee, Leelawattana Rattana, Rattarasarn Chatchalit

机构信息

Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Endocr J. 2014;61(1):77-83. doi: 10.1507/endocrj.ej13-0241. Epub 2013 Oct 22.

Abstract

Muscle mass inversely relates to 2 hours glucose levels after oral glucose load in non-diabetic subjects. A study in glucose intolerance subjects has never been performed. We conducted this study to determine the relationship between muscle mass and glucose level after oral glucose load in glucose intolerance subjects. Sixty Thai subjects, 44 drug-naïve, newly diagnosed type 2 diabetes mellitus and 16 impaired glucose tolerance were studied. The 180 min 75 g oral glucose tolerance test was performed. Total body fat and lean mass were measured by dual-energy x-ray absorptiometry. Insulin sensitivity was determined by insulin sensitivity index using model of Matsuda & DeFronzo. The 1st-phase and total insulin secretion were determined from glucose tolerance data. Pearson correlation and linear regression were used for the analysis. Lean mass was inversely correlated with area-under-curves of glucose 0-180 min (r =-0.320; p=0.013). The relationship was significant after adjustment with age and body-mass-index (r =-0.350; p=0.007). Area-under-curves of glucose 0-180 min was correlated with height (r =-0.282; p=0.029), fasting glucose (r =0.742; p<0.0001), log area-under-curves of insulin 0-180 min (r =-0.258; p=0.047) and log 1st-phase insulin secretion (r =-0.518; p<0.0001). By multivariate analysis, fasting glucose (standardized β=4.54; p<0.001), log 1st-phase insulin secretion (standardized β=-43.09; p=0.005) and lean mass (standardized β=-0.003; p=0.011) were the significant parameters predicting area-under-curves of glucose 0-180 min. In conclusion, lean mass inversely predicted glucose levels after oral glucose load independent of insulin secretion and insulin sensitivity in glucose intolerance subjects.

摘要

在非糖尿病受试者中,肌肉量与口服葡萄糖负荷后2小时血糖水平呈负相关。尚未对葡萄糖耐量异常受试者进行过相关研究。我们开展这项研究以确定葡萄糖耐量异常受试者口服葡萄糖负荷后肌肉量与血糖水平之间的关系。对60名泰国受试者进行了研究,其中44名未接受过药物治疗、新诊断的2型糖尿病患者以及16名糖耐量受损患者。进行了180分钟75克口服葡萄糖耐量试验。采用双能X线吸收法测量全身脂肪和瘦体重。使用松田和德弗龙佐模型通过胰岛素敏感性指数确定胰岛素敏感性。根据葡萄糖耐量数据确定第一阶段和总胰岛素分泌。采用Pearson相关性分析和线性回归进行分析。瘦体重与0 - 180分钟葡萄糖曲线下面积呈负相关(r = -0.320;p = 0.013)。在对年龄和体重指数进行校正后,这种关系仍然显著(r = -0.350;p = 0.007)。0 - 180分钟葡萄糖曲线下面积与身高(r = -0.282;p = 0.029)、空腹血糖(r = 0.742;p < 0.0001)、0 - 180分钟胰岛素曲线下面积对数(r = -0.258;p = 0.047)以及第一阶段胰岛素分泌对数(r = -0.518;p < 0.0001)相关。通过多变量分析,空腹血糖(标准化β = 4.54;p < 0.001)、第一阶段胰岛素分泌对数(标准化β = -43.09;p = 0.005)和瘦体重(标准化β = -0.003;p = 0.011)是预测0 - 180分钟葡萄糖曲线下面积的显著参数。总之,在葡萄糖耐量异常受试者中,瘦体重可独立于胰岛素分泌和胰岛素敏感性反向预测口服葡萄糖负荷后的血糖水平。

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