Firth R, Bell P, Rizza R
Endocrine Research Unit, Mayo Clinic and Foundation, Rochester, MN.
Metabolism. 1987 Nov;36(11):1091-5. doi: 10.1016/0026-0495(87)90031-x.
To determine the contribution of obesity to the insulin resistance of non-insulin-dependent diabetes mellitus, insulin dose response curves for suppression of glucose production and stimulation of glucose utilization were generated in lean and obese diabetic patients and compared to those observed in weight-matched nondiabetic subjects. Glucose utilization during 0.4, 1.0, and 10.0 mU/kg x min insulin infusions (producing insulin concentrations ranging from approximately 50 to 2,000 microU/mL) was lower (p less than .02 to .001) in lean and obese diabetic patients compared to weight-matched nondiabetic subjects indicating insulin resistance. Glucose utilization was not correlated with obesity in the diabetic subjects. Suppression of glucose production was impaired (P less than .03 and .001) in both the lean and obese diabetic subjects at physiologic but not supraphysiologic insulin concentrations. We conclude that patients with NIDDM have both hepatic and extrahepatic insulin resistance, the severity of which appears to be independent of the degree of obesity.
为了确定肥胖对非胰岛素依赖型糖尿病胰岛素抵抗的影响，我们测定了肥胖和非肥胖糖尿病患者抑制葡萄糖生成及刺激葡萄糖利用的胰岛素剂量反应曲线，并与体重匹配的非糖尿病受试者的曲线进行比较。在输注胰岛素剂量为0.4、1.0和10.0 mU/kg×min时（产生的胰岛素浓度范围约为50至2,000 μU/mL），肥胖和非肥胖糖尿病患者的葡萄糖利用率低于体重匹配的非糖尿病受试者（P＜0.02至0.001），表明存在胰岛素抵抗。在糖尿病受试者中，葡萄糖利用率与肥胖无关。在生理胰岛素浓度而非超生理胰岛素浓度下，肥胖和非肥胖糖尿病患者的葡萄糖生成抑制均受损（P＜0.03和0.001）。我们得出结论，非胰岛素依赖型糖尿病患者存在肝内和肝外胰岛素抵抗，其严重程度似乎与肥胖程度无关。
