Bagdade J D, Bierman E L, Porte D
J Clin Invest. 1967 Oct;46(10):1549-57. doi: 10.1172/JCI105646.
The level of insulin after an overnight fast (basal) in 37 obese and nonobese male subjects with normal and abnormal carbohydrate tolerance was directly related to the increase in insulin concentration during a 3 hr 100 g oral glucose tolerance test. Obesity, but not diabetes, was associated with an elevation of this basal insulin level. Thus obesity predicted with the magnitude of the insulin response to glucose ingestion. When the individual insulin values were expressed as per cent change from the basal level, this effect of obesity was excluded. The insulin levels of all subjects with normal carbohydrate tolerance promptly rose 5-7-fold, and reached peak values 1 hr after oral glucose. In contrast, the diabetic response (as per cent increase) was markedly reduced during the 1st hr, and maximal (but still subnormal) insulin levels were not attained until 2 hr. In all subjects the insulin response (quantitated by calculation of the area circumscribed by a plot of the per cent change in insulin with time) showed a significant inverse correlation with the glucose response. Thus increasing degrees of carbohydrate intolerance were associated with decreasing insulin responses. Elevated levels of insulin, in both the basal state and in response to glucose, were related to obesity.
在37名具有正常和异常糖耐量的肥胖和非肥胖男性受试者中，空腹过夜（基础）胰岛素水平与3小时100克口服葡萄糖耐量试验期间胰岛素浓度的升高直接相关。肥胖而非糖尿病与这种基础胰岛素水平升高有关。因此，肥胖可预测对葡萄糖摄入的胰岛素反应程度。当将个体胰岛素值表示为相对于基础水平的百分比变化时，肥胖的这种影响被排除。所有糖耐量正常的受试者的胰岛素水平迅速上升5至7倍，并在口服葡萄糖后1小时达到峰值。相比之下，糖尿病患者的反应（以百分比增加表示）在第1小时明显降低，直到2小时才达到最大（但仍低于正常）胰岛素水平。在所有受试者中，胰岛素反应（通过计算胰岛素随时间变化百分比的曲线所围成的面积来定量）与葡萄糖反应呈显著负相关。因此，碳水化合物不耐受程度的增加与胰岛素反应的降低有关。基础状态和对葡萄糖反应时的胰岛素水平升高均与肥胖有关。
