Haffner S M, Stern M P, Miettinen H, Gingerich R, Bowsher R R
Division of Clinical Epidemiology, University of Texas Health Science Center at San Antonio 78284-7873, USA.
Diabetes. 1995 Oct;44(10):1156-60. doi: 10.2337/diab.44.10.1156.
Both insulin resistance and decreased insulin secretion have been hypothesized to be precursors of non-insulin-dependent diabetes. An elevated proinsulin concentration reflects abnormal proinsulin processing and could indicate abnormal insulin secretion. We examined fasting insulin (measured by a radioimmunoassay that does not cross-react with proinsulin), as a marker of insulin resistance, and proinsulin and the fasting proinsulin-to-insulin ratio, as markers of impaired proinsulin processing, in 597 nondiabetic Mexican-Americans from the San Antonio Heart Study. Fasting insulin, proinsulin, and the fasting proinsulin-to-insulin ratio were higher in subjects with a parental history of diabetes than in subjects without such a history. These differences remained statistically significant after adjustment for obesity, body fat distribution, and glucose tolerance. A parental history of diabetes in nondiabetic Mexican-Americans is associated with an increase in fasting specific insulin and a disproportionate increase in proinsulin relative to insulin. These data suggest that both increased insulin resistance and abnormal processing of proinsulin are present in offspring of parents with diabetes.
胰岛素抵抗和胰岛素分泌减少均被认为是非胰岛素依赖型糖尿病的先兆。胰岛素原浓度升高反映了胰岛素原加工异常，可能表明胰岛素分泌异常。我们在圣安东尼奥心脏研究中，对597名非糖尿病墨西哥裔美国人进行了检测，将空腹胰岛素（通过与胰岛素原无交叉反应的放射免疫分析法测定）作为胰岛素抵抗的标志物，将胰岛素原以及空腹胰岛素原与胰岛素的比值作为胰岛素原加工受损的标志物。有糖尿病家族史的受试者的空腹胰岛素、胰岛素原以及空腹胰岛素原与胰岛素的比值，高于无此家族史的受试者。在对肥胖、体脂分布和糖耐量进行校正后，这些差异仍具有统计学意义。非糖尿病墨西哥裔美国人的糖尿病家族史与空腹特异性胰岛素增加以及胰岛素原相对于胰岛素不成比例的增加有关。这些数据表明，糖尿病患者后代同时存在胰岛素抵抗增加和胰岛素原加工异常的情况。
