Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA.
School of Medicine, University of Missouri, Columbia, Missouri, USA.
Obesity (Silver Spring). 2024 Mar;32(3):540-546. doi: 10.1002/oby.23963. Epub 2024 Jan 16.
The objective of this study was to evaluate the relative importance of the basal rate of glucose appearance (Ra) in the circulation and the basal rate of plasma glucose clearance in determining fasting plasma glucose concentration in people with obesity and different fasting glycemic statuses.
The authors evaluated basal glucose kinetics in 33 lean people with normal fasting glucose (<100 mg/dL; Lean < 100 group) and 206 people with obesity and normal fasting glucose (Ob < 100 group, n = 118), impaired fasting glucose (100-125 mg/dL; Ob 100-125 group, n = 66), or fasting glucose diagnostic of diabetes (≥126 mg/dL; Ob ≥ 126 group, n = 22).
Although there was a large (up to three-fold) range in glucose Ra within each group, the ranges in glucose concentration in the Lean < 100, Ob < 100, and Ob 100-125 groups were small because of a close relationship between glucose Ra and clearance rate. However, the glucose clearance rate at any Ra value was lower in the hyperglycemic than the normoglycemic groups. In the Ob ≥ 126 group, plasma glucose concentration was primarily determined by glucose Ra, because glucose clearance was markedly attenuated.
Fasting hyperglycemia in people with obesity represents a disruption of the precisely regulated integration of glucose production and clearance rates.
本研究旨在评估循环中葡萄糖出现率（Ra）的基础率和基础血糖清除率在确定肥胖人群不同空腹血糖状态下的空腹血糖浓度中的相对重要性。
作者评估了 33 名空腹血糖正常（<100mg/dL；Lean < 100 组）和 206 名肥胖且空腹血糖正常（Ob < 100 组，n=118）、空腹血糖受损（100-125mg/dL；Ob 100-125 组，n=66）或空腹血糖诊断为糖尿病（≥126mg/dL；Ob ≥ 126 组，n=22）的肥胖人群的基础葡萄糖动力学。
尽管在每个组中，葡萄糖 Ra 有很大的（高达三倍）范围，但由于葡萄糖 Ra 和清除率之间的密切关系，Lean < 100、Ob < 100 和 Ob 100-125 组的葡萄糖浓度范围很小。然而，在任何 Ra 值下，高血糖组的葡萄糖清除率都低于正常血糖组。在 Ob ≥ 126 组中，由于葡萄糖清除明显减弱，血糖浓度主要由葡萄糖 Ra 决定。
肥胖人群的空腹高血糖代表了葡萄糖产生和清除率的精确调节整合的破坏。
