Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne NE4 5PL, UK.
Newcastle Magnetic Resonance Centre, Institute of Cellular Medicine, Newcastle University, Campus for Ageing & Vitality, Newcastle upon Tyne NE4 5PL, UK.
Cell Metab. 2018 Oct 2;28(4):547-556.e3. doi: 10.1016/j.cmet.2018.07.003. Epub 2018 Aug 2.
The Diabetes Remission Clinical Trial reported return and persistence of non-diabetic blood glucose control in 46% of people with type 2 diabetes of up to 6 years duration. Detailed metabolic studies were performed on a subgroup (intervention, n = 64; control, n = 26). In the intervention group, liver fat content decreased (16.0% ± 1.3% to 3.1% ± 0.5%, p < 0.0001) immediately after weight loss. Similarly, plasma triglyceride and pancreas fat content decreased whether or not glucose control normalized. Recovery of first-phase insulin response (0.04[-0.05-0.32] to 0.11[0.0005-0.51] nmol/min/m, p < 0.0001) defined those who returned to non-diabetic glucose control and this was durable at 12 months (0.11[0.005-0.81] nmol/min/m, p = 0.0001). Responders were similar to non-responders at baseline but had shorter diabetes duration (2.7 ± 0.3 versus 3.8 ± 0.4 years; p = 0.02). This study demonstrates that β cell ability to recover long-term function persists after diagnosis, changing the previous paradigm of irreversible loss of β cell function in type 2 diabetes.
该研究报告称，在 6 年病程的 2 型糖尿病患者中，有 46%的患者血糖恢复并维持在非糖尿病水平。在干预组中，肝脏脂肪含量在体重减轻后立即下降（16.0%±1.3%降至 3.1%±0.5%，p<0.0001）。同样，无论血糖是否恢复正常，血浆甘油三酯和胰腺脂肪含量也会下降。第一时相胰岛素反应的恢复（0.04[-0.05-0.32]至 0.11[0.0005-0.51]nmol/min/m，p<0.0001）定义了那些血糖恢复到非糖尿病水平的患者，并且这种恢复在 12 个月时是持久的（0.11[0.005-0.81]nmol/min/m，p=0.0001）。与非应答者相比，应答者在基线时相似，但糖尿病病程较短（2.7±0.3 年与 3.8±0.4 年；p=0.02）。这项研究表明，β细胞恢复长期功能的能力在诊断后仍然存在，改变了 2 型糖尿病中β细胞功能不可逆转丧失的先前模式。
