Takeuchi Mika, Wu Bin, Honda Mari, Tsuboi Ayaka, Kitaoka Kaori, Minato Satomi, Kurata Miki, Kazumi Tsutomu, Fukuo Keisuke
Research Institute for Nutrition Sciences, Mukogawa Women's University, Nishinomiya, Japan.
Open Research Center for Studying of Lifestyle-Related Diseases, Mukogawa Women's University, Nishinomiya, Japan.
BMJ Open Diabetes Res Care. 2020 May;8(1). doi: 10.1136/bmjdrc-2020-001244.
To assess vascular function and characterize insulin secretion using a physiological approach in Japanese women with family history of type 2 diabetes (FHD).
Standardized mixed-meal tests were performed with multiple postprandial glucose, insulin and free fatty acids (FFA) measurements over a 30-120 min period in 31 Japanese women aged 21-24 years. Arterial distensibility was assessed as well.
Fasting glucose, triglyceride and insulin averaged <90 mg/dL, <60 mg/dL and <5 μU/mL, respectively, and did not differ cross-sectionally between 10 with (FHD+) and 21 without FHD (FHD-). FHD+ showed higher insulin responses not only during the first 30 min (p=0.005) but also during the second hour (60-120 min, p<0,05) in spite of identical postprandial suppression of FFA and identical fasting and postprandial glucose and FFA concentrations, except for higher 60 min FFA in FHD+. Further, FHD+ had decreased arterial distensibility (p=0.003). On multivariate regression analysis, arterial distensibility emerged as the only significant independent predictor of FHD+. Endurance training in FHD+ did not alter decreased arterial distensibility whereas it abolished postprandial hyperinsulinemia.
FHD was associated with decreased arterial distensibility and postprandial hyperinsulinemia despite nearly identical postprandial glycemia and postprandial FFA suppression, suggesting that impaired vascular insulin sensitivity may precede glucose and lipid dysmetabolism in normal weight Japanese women aged 22 years.
采用生理学方法评估有2型糖尿病家族史（FHD）的日本女性的血管功能并描述胰岛素分泌特征。
对31名年龄在21 - 24岁的日本女性进行标准化混合餐试验，在30 - 120分钟内多次测量餐后血糖、胰岛素和游离脂肪酸（FFA）。同时评估动脉扩张性。
空腹血糖、甘油三酯和胰岛素平均分别<90mg/dL、<60mg/dL和<5μU/mL，有FHD的10名女性（FHD +）和无FHD的21名女性（FHD -）之间的横断面数据无差异。尽管FHD +餐后FFA抑制相同，空腹及餐后血糖和FFA浓度相同，但FHD +不仅在最初30分钟内胰岛素反应更高（p = 0.005），在第二小时（60 - 120分钟，p < 0.05）也更高，只是FHD +的60分钟FFA更高。此外，FHD +的动脉扩张性降低（p = 0.003）。多变量回归分析显示，动脉扩张性是FHD +唯一显著的独立预测因素。FHD +进行耐力训练并未改变降低的动脉扩张性，但消除了餐后高胰岛素血症。
尽管餐后血糖和餐后FFA抑制几乎相同，但FHD与动脉扩张性降低和餐后高胰岛素血症相关，这表明在22岁正常体重的日本女性中，血管胰岛素敏感性受损可能先于葡萄糖和脂质代谢紊乱出现。
