Diabetes Research Group, Life Sciences Institute, Department of Cellular and Physiological Sciences, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.
Institute for Personalized Therapeutic Nutrition, Vancouver, BC, Canada.
Diabetologia. 2021 Oct;64(10):2138-2146. doi: 10.1007/s00125-021-05505-4. Epub 2021 Jul 22.
Hundreds of millions of people are affected by hyperinsulinaemia, insulin resistance, obesity and the dysglycaemia that mark a common progression from metabolic health to type 2 diabetes. Although the relative contribution of these features and the order in which they appear may differ between individuals, the common clustering and seemingly progressive nature of type 2 diabetes aetiology has guided research and clinical practice in this area for decades. At the same time, lively debate around the causal relationships between these features has continued, as new data from human trials and highly controlled animal studies are presented. This 'For debate' article was prompted by the review in Diabetologia by Esser, Utzschneider and Kahn ( https://doi.org/10.1007/s00125-020-05245-x ), with the purpose of reviewing established and emerging data that provide insight into the relative contributions of hyperinsulinaemia and impaired glucose-stimulated insulin secretion in progressive stages between health, obesity and diabetes. It is concluded that these beta cell defects are not mutually exclusive and that they are both important, but at different stages.
数以亿计的人受到高胰岛素血症、胰岛素抵抗、肥胖以及标志着从代谢健康向 2 型糖尿病进展的常见糖代谢异常的影响。尽管这些特征的相对贡献以及它们出现的顺序在个体之间可能有所不同，但 2 型糖尿病病因的常见聚类和看似渐进的性质指导了该领域的研究和临床实践数十年。与此同时，随着人类试验和高度受控的动物研究中提出的新数据，围绕这些特征之间的因果关系的激烈辩论仍在继续。本文是受 Diabetologia 杂志上 Esser、Utzschneider 和 Kahn 的综述的启发而撰写的（https://doi.org/10.1007/s00125-020-05245-x），旨在回顾提供有关健康、肥胖和糖尿病之间的渐进阶段中高胰岛素血症和葡萄糖刺激的胰岛素分泌受损相对贡献的既定和新兴数据。结论是这些β细胞缺陷并非互斥的，它们都很重要，但在不同阶段。
