Naimi Foued, Laflèche Christophe Richer Dit, Battista Marie-Claude, Carpentier André C, Baillargeon Jean-Patrice
Division of Endocrinology, Department of Medicine, University of Sherbrooke (Université de Sherbrooke), Sherbrooke, QC, Canada.
Research Centre of the Sherbrooke University Hospital Centre (Centre de recherche du Centre hospitalier universitaire de Sherbrooke), Sherbrooke, QC, Canada.
Endocrinol Metab (Seoul). 2025 Aug;40(4):561-573. doi: 10.3803/EnM.2024.2129. Epub 2025 Mar 18.
Tissue overexposure to non-esterified fatty acids (NEFA) contributes to the development of metabolic conditions, with insulin-mediated suppression of lipolysis being an important mechanism in limiting this overexposure. We investigated which dynamic NEFA insulin-suppression indices derived from the oral glucose tolerance test (OGTT) were best associated with those derived from the insulin-glucose clamp, as well as with central adiposity and glucoregulatory parameters.
This cross-sectional study recruited 29 women without diabetes, 15 healthy women, and 14 women with polycystic ovary syndrome. The OGTT indices of NEFA insulin-suppression were the decremental NEFA area under the curve, negative log-linear NEFA slope, percentage of NEFA suppression (%NEFAsupp) and time to suppress NEFA levels by 50% (T50NEFA). The indices derived from the two-step euglycemic-hyperinsulinemic clamp (low-dose insulin step) were delta NEFA and %NEFAsupp.
Among the OGTT and clamp indices, T50NEFA[OGTT] and %NEFAsupp[clamp] showed the closest associations in both subgroups (r=-0.58). Additionally, T50NEFA correlated significantly in all women with waist circumference (r=0.64), body fat percentage (r=0.60), fasting insulinemia (r=0.53), and M-value insulin sensitivity index (r=-0.45). Similarly, %NEFAsupp[clamp] correlated significantly in all women with waist circumference (r=-0.57), body fat percentage (r=-0.54), fasting insulinemia (r=-0.55), and M-value insulin sensitivity index (r=0.51). T50NEFA and %NEFAsupp[clamp] also correlated with other anthropometric and metabolic parameters associated with lipotoxicity.
For dynamic testing of NEFA insulin-suppression in women, T50NEFA was the OGTT-derived index best correlated with a clamp index (%NEFAsupp). These indices were also the most closely associated with anthropometric and glucoregulatory parameters. Thus, the OGTT-derived T50NEFA appears valid for assessing dynamic antilipolytic insulin action.
组织过度暴露于非酯化脂肪酸（NEFA）会导致代谢状况的发展，胰岛素介导的脂肪分解抑制是限制这种过度暴露的重要机制。我们研究了哪些源自口服葡萄糖耐量试验（OGTT）的动态NEFA胰岛素抑制指数与源自胰岛素-葡萄糖钳夹试验的指数、中心性肥胖和糖调节参数最相关。
这项横断面研究招募了29名无糖尿病女性、15名健康女性和14名多囊卵巢综合征女性。OGTT的NEFA胰岛素抑制指数包括曲线下递减NEFA面积、负对数线性NEFA斜率、NEFA抑制百分比（%NEFAsupp）以及将NEFA水平抑制50%的时间（T50NEFA）。源自两步正常血糖-高胰岛素钳夹试验（低剂量胰岛素步骤）的指数为ΔNEFA和%NEFAsupp。
在OGTT和钳夹试验指数中，T50NEFA[OGTT]和%NEFAsupp[钳夹试验]在两个亚组中显示出最密切的相关性（r = -0.58）。此外，T50NEFA在所有女性中与腰围（r = 0.64）、体脂百分比（r = 0.60）、空腹胰岛素血症（r = 0.53）和M值胰岛素敏感性指数（r = -0.45）显著相关。同样，%NEFAsupp[钳夹试验]在所有女性中与腰围（r = -0.57）、体脂百分比（r = -0.54）、空腹胰岛素血症（r = -0.55）和M值胰岛素敏感性指数（r = 0.51）显著相关。T50NEFA和%NEFAsupp[钳夹试验]也与其他与脂毒性相关的人体测量和代谢参数相关。
对于女性NEFA胰岛素抑制的动态检测，T50NEFA是与钳夹试验指数（%NEFAsupp）相关性最好的源自OGTT的指数。这些指数也与人体测量和糖调节参数最密切相关。因此，源自OGTT的T50NEFA似乎可有效评估动态抗脂解胰岛素作用。
