Peiris A N, Struve M F, Kissebah A H
Clinical Research Center, Medical College of Wisconsin, Milwaukee 53226.
Int J Obes. 1987;11(6):581-9.
The effects of body fat distribution on the metabolic clearance rate of insulin (MCR) and its relationship to peripheral insulin sensitivity (M/I) and androgenic activity were assessed in six nonobese and 20 obese premenopausal women with varying waist-to-hip girth ratio (WHR). As an index of androgenic activity, plasma levels of the sex hormone binding globulin (SHBG) and percentage free testosterone (%FT) were determined. The mean MCR in the obese and nonobese groups were similar (571 +/- 29 vs 578 +/- 31 ml/min/m2). Within the obese group, MCR varied between 401 and 822 ml/min/m2 and was inversely correlated with the WHR (r = -0.50, P less than 0.05). The reduction in MCR with upper body fat localization was observed at both sub- and supra-maximal plasma insulin levels. MCR correlated negatively with fasting and postglucose challenge plasma insulin levels and positively with M/I. MCR also correlated with plasma SHBG and %FT levels. We conclude that upper body fat localization is associated with diminished insulin clearance. This diminution is closely aligned with the degree of peripheral insulinemia and insulin sensitivity. The increase in androgenic activity may contribute to the aberrant insulin clearance observed in upper body obese subjects.
在6名非肥胖和20名肥胖的绝经前女性中，评估了体脂分布对胰岛素代谢清除率（MCR）的影响及其与外周胰岛素敏感性（M/I）和雄激素活性的关系，这些女性的腰臀围比（WHR）各不相同。作为雄激素活性的指标，测定了性激素结合球蛋白（SHBG）的血浆水平和游离睾酮百分比（%FT）。肥胖组和非肥胖组的平均MCR相似（571± 29 vs 578± 31 ml/min/m2）。在肥胖组中，MCR在401至822 ml/min/m2之间变化，并且与WHR呈负相关（r = -0.50，P<0.05）。在低于和高于最大血浆胰岛素水平时，均观察到上半身脂肪堆积导致MCR降低。MCR与空腹和葡萄糖激发后血浆胰岛素水平呈负相关，与M/I呈正相关。MCR还与血浆SHBG和%FT水平相关。我们得出结论，上半身脂肪堆积与胰岛素清除率降低有关。这种降低与外周胰岛素血症和胰岛素敏感性程度密切相关。雄激素活性增加可能导致上半身肥胖受试者出现异常的胰岛素清除。
