[不同糖耐量水平肥胖个体异位脂肪堆积与胰岛素敏感性的相关性]
[Correlation between ectopic fat accumulation and insulin sensitivity in obese individuals with different glucose tolerance levels].
作者信息
Lai Shui-Qing, Hong Zhen-Zhen, Chen Hong-Mei, Lin Jin-Xin, Kuang Jian, Li Yan-Bing
机构信息
Department of Endocrinology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, China. E-mail:
出版信息
Nan Fang Yi Ke Da Xue Xue Bao. 2017 Nov 20;37(11):1461-1466. doi: 10.3969/j.issn.1673-4254.2017.11.06.
OBJECTIVE
To investigate the correlation between liver and skeletal muscle fat contents and insulin resistance in obese individuals with different levels of glucose tolerance.
METHODS
RESULTS: Ten non-obese individuals with normal glucose tolerance (NGT), 9 obese individuals with NGT, and 7 obese individuals with impaired glucose tolerance (IGT) were enrolled in this study. All the participants were examined for insulin sensitivity by hyperinsulinemic-euglycemic clamp and for liver and skeletal muscle fat accumulation quantified by proton magnetic resonance spectroscopy (1H MRS). The data were collected from the subjects including somatometric measurements, fasting plasma glucose, 2-h plasma glucose (2hPG), fasting insulin, and blood biochemistry. Linear correlation analysis and multiple linear stepwise regression analysis were used to analyze the relationship between ectopic fat accumulation and insulin resistance.
RESULTS
The glucose infusion rates (GIR, presented as the M value) differed significantly among IGT-obese (3.95∓1.66 mg·kg·min), NGT-obese (6.14∓1.90 mg·kg·min) and NGT-non-obese (8.78∓2.46 mg·kg·min) groups (P<0.05). The 3 groups also showed significant differences in liver fat contents [(15.23∓3.09)%, (6.25∓0.38)%, and (1.89∓0.90)%, respectively, P<0.05] and intramyocellular lipids in the tibialis anterior (2.69∓0.95, 2.61∓1.45, and 1.54∓0.66 mmol/kg, respectively, P<0.05). Linear analysis revealed that liver fat content, but not skeletal muscle fat content, was significantly correlated with the M value. Multiple linear stepwise regression analysis using M value as the dependent variable (Y) revealed that liver fat content (X) was an independent factor inversely correlated with the M value (regression equation: Y=-30.562X+9.007, R=0.717, P<0.01).
CONCLUSIONS
Liver fat accumulation, but not skeletal muscle fat accumulation, is correlated with insulin resistance and impaired glucose metabolism.
目的
探讨不同糖耐量水平的肥胖个体肝脏和骨骼肌脂肪含量与胰岛素抵抗之间的相关性。
方法
结果：本研究纳入了10名糖耐量正常（NGT）的非肥胖个体、9名糖耐量正常的肥胖个体以及7名糖耐量受损（IGT）的肥胖个体。所有参与者均通过高胰岛素-正常血糖钳夹技术检测胰岛素敏感性，并通过质子磁共振波谱（1H MRS）对肝脏和骨骼肌脂肪堆积进行定量分析。收集受试者的体测数据、空腹血糖、2小时血糖（2hPG）、空腹胰岛素及血液生化指标。采用线性相关分析和多元线性逐步回归分析来分析异位脂肪堆积与胰岛素抵抗之间的关系。
结果
IGT肥胖组（3.95±1.66mg·kg·min）、NGT肥胖组（6.14±1.9mg·kg·min）和NGT非肥胖组（8.78±2.46mg·kg·min）的葡萄糖输注率（GIR，以M值表示）差异有统计学意义（P<0.05）。三组在肝脏脂肪含量[分别为(15.23±3.09)%、(6.25±0.38)%和(1.89±0.90)%，P<0.05]以及胫骨前肌细胞内脂质含量（分别为2.69±0.95、2.61±1.45和1.54±0.66mmol/kg，P<0.05）方面也存在显著差异。线性分析显示，肝脏脂肪含量而非骨骼肌脂肪含量与M值显著相关。以M值为因变量（Y）进行多元线性逐步回归分析发现，肝脏脂肪含量（X）是与M值呈负相关的独立因素（回归方程：Y=-30.562X+9.007，R=0.717，P<0.01）。
结论
肝脏脂肪堆积而非骨骼肌脂肪堆积与胰岛素抵抗及糖代谢受损相关。
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