Murai Norimitsu, Saito Naoko, Kodama Eriko, Iida Tatsuya, Mikura Kentaro, Imai Hideyuki, Kaji Mariko, Hashizume Mai, Kigawa Yasuyoshi, Koizumi Go, Tadokoro Rie, Sugisawa Chiho, Endo Kei, Iizaka Toru, Saiki Ryo, Otsuka Fumiko, Ishibashi Shun, Nagasaka Shoichiro
Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University, Tochigi, Japan.
J Endocr Soc. 2020 Jun 5;4(7):bvaa066. doi: 10.1210/jendso/bvaa066. eCollection 2020 Jul 1.
Slight elevations in plasma glucose (PG) manifest in advance of diabetes onset, but abnormalities in immunoreactive insulin (IRI), proinsulin (Pro), and adiponectin dynamics during this stage remain poorly understood.
The objective of this work is to investigate whether IRI and Pro dynamics become abnormal as glucose tolerance deteriorates from within the normal range toward impaired glucose tolerance (IGT), as well as the relationship between PG, and these dynamics and serum adiponectin levels.
A cross-sectional study was designed.
This study took place at Jichi Medical University in Japan.
PG, IRI, and Pro levels were determined in 1311 young Japanese individuals (age < 40 years) with normal or IGT before and at 30, 60, and 120 minutes during a 75-g oral glucose tolerance test. Participants were assigned to 4 groups according to glucose tolerance, and then background factors, adiponectin levels, insulin sensitivity (SI), and insulin secretion (β) indexes were determined.
PG levels as well as IRI and Pro levels 60 and 120 minutes after glucose-loading increased incrementally with deteriorating glucose tolerance. All measures of β and the SI measure index of insulin sensitivity (ISI)-Matsuda decreased incrementally. Serum adiponectin levels were not significantly different among the glucose tolerance groups, but were independently and negatively correlated with fasting glucose.
Early β decreased and postloading Pro levels became excessive in a progressive manner as glucose tolerance deteriorated from within the normal range toward IGT.
血浆葡萄糖（PG）水平的轻微升高在糖尿病发病之前就已出现，但在此阶段免疫反应性胰岛素（IRI）、胰岛素原（Pro）和脂联素动态变化的异常情况仍知之甚少。
本研究旨在调查随着葡萄糖耐量从正常范围向糖耐量受损（IGT）恶化，IRI和Pro动态变化是否会变得异常，以及PG、这些动态变化与血清脂联素水平之间的关系。
设计了一项横断面研究。
本研究在日本自治医科大学进行。
在1311名年龄小于40岁、葡萄糖耐量正常或为IGT的年轻日本个体中，于75克口服葡萄糖耐量试验前及试验开始后30、60和120分钟测定PG、IRI和Pro水平。根据葡萄糖耐量将参与者分为4组，然后测定背景因素、脂联素水平、胰岛素敏感性（SI）和胰岛素分泌（β）指数。
随着葡萄糖耐量的恶化，葡萄糖负荷后60和120分钟的PG水平以及IRI和Pro水平逐渐升高。β的所有测量指标以及胰岛素敏感性的SI测量指数（ISI）-松田指数均逐渐下降。葡萄糖耐量组之间的血清脂联素水平无显著差异，但与空腹血糖呈独立负相关。
随着葡萄糖耐量从正常范围向IGT恶化，早期β降低，负荷后Pro水平逐渐过度升高。
