Cederholm J, Wibell L
Scand J Clin Lab Invest. 1985 Dec;45(8):741-51. doi: 10.3109/00365518509155289.
With use of 75 g oral glucose tolerance tests (OGTTs), insulin release and relative peripheral resistance were evaluated in groups of normoglycaemic subjects, subjects with glucose intolerance (GI) and patients with non-insulin-dependent diabetes mellitus (NIDDM). Insulin release was expressed as the total area under the insulin curve (AUCI) and as the area under the insulin curve above the fasting insulin level (delta AUCI). The insulin response to glucose was expressed as the ratio of the area under the insulin curve to that of the glucose curve above fasting levels (delta AUCI/delta AUCG). The glucose uptake rate during the OGTT (M) was measured as the difference between the glucose load and the increase of the amount of glucose in the glucose space after, compared to before, the OGTT. The relative peripheral resistance against glucose uptake promoting factors (rel-R) was expressed as 1/M. With application of these indices in the non-obese groups, there was an increased mean total insulin release (AUCI, delta AUCI) while the mean insulin response to glucose (delta AUCI/delta AUCG) was decreased in GI-subjects compared with normoglycaemic subjects. The mean relative peripheral resistance (rel-R) was higher in GI-subjects than in normoglycaemics. Mean values of AUCI and delta AUCI were decreased (lower than in the normoglycaemics, NS), mean values of delta AUCI/delta AUCG were further decreased and mean values of rel-R were further increased in the NIDDM-groups compared with the GI-group. Insulin release was delayed in GI and NIDDM. Obese normal and obese GI-subjects with similar rel-R values as the corresponding non-obese normal and non-obese GI-subjects, had higher mean values of insulin release than the non-obese counterparts. Thus, it seemed possible to use a technique in general use, the OGTT, with a partly new approach to simultaneously obtain indices for insulin release and relative peripheral resistance, which may have clinical applicability.
使用75克口服葡萄糖耐量试验（OGTT），对正常血糖受试者、糖耐量异常（GI）受试者和非胰岛素依赖型糖尿病（NIDDM）患者组进行胰岛素释放和相对外周阻力评估。胰岛素释放以胰岛素曲线下总面积（AUCI）以及高于空腹胰岛素水平的胰岛素曲线下面积（delta AUCI）表示。胰岛素对葡萄糖的反应以胰岛素曲线下面积与空腹水平以上葡萄糖曲线下面积之比（delta AUCI/delta AUCG）表示。OGTT期间的葡萄糖摄取率（M）通过测量葡萄糖负荷与OGTT后葡萄糖空间中葡萄糖量相对于OGTT前增加量之间的差值来确定。对促进葡萄糖摄取因子的相对外周阻力（rel-R）表示为1/M。在非肥胖组应用这些指标时，与正常血糖受试者相比，GI受试者的平均总胰岛素释放（AUCI、delta AUCI）增加，而胰岛素对葡萄糖的平均反应（delta AUCI/delta AUCG）降低。GI受试者的平均相对外周阻力（rel-R）高于正常血糖者。与GI组相比，NIDDM组的AUCI和delta AUCI平均值降低（低于正常血糖者，无显著性差异），delta AUCI/delta AUCG平均值进一步降低，rel-R平均值进一步升高。GI和NIDDM患者的胰岛素释放延迟。肥胖正常人和肥胖GI受试者与相应的非肥胖正常人和非肥胖GI受试者具有相似的rel-R值，但胰岛素释放平均值高于非肥胖对应者。因此，似乎可以采用一种常用技术——OGTT，并采用部分新方法同时获得胰岛素释放和相对外周阻力指标，这可能具有临床应用价值。
