Wasada T, Kuroki H, Arii H, Maruyama A, Aoki K, Katsumori K, Saito S, Hanada H, Omori Y
Diabetes Center, Tokyo Women's Medical College, Japan.
Diabetes Res Clin Pract. 1994 Oct;25(3):191-8. doi: 10.1016/0168-8227(94)90008-6.
To investigate whether a resistance to insulin-stimulated glucose uptake (IR) is associated with the risk factors (RF) for cardiovascular disease (CVD) in non-insulin-dependent diabetic (NIDDM) patients, we determined the degree of IR in 135 adult NIDDM patients who had no advanced diabetic complications. The euglycemic (80 mg/dl) hyperinsulinemic clamp (insulin infusion rate 1.12 mU/kg per min) was performed and the average glucose infusion rate (GIR) during a steady-state euglycemia was determined as a measure of IR. Hypertension was more common among NIDDM patients with an increased IR and was highest in the group of patients with CVD. CVD-RF such as hypertension, hypertriglyceridemia, low HDL-cholesterol and obesity tended to cluster in the NIDDM patients who had lower GIR values and higher fasting IRI levels. GIR values were compared between a set of groups extracted from the 135 NIDDM patients that were matched for age, sex, body mass index and HbA1c levels. The CVD-positive group had the significantly lower GIR value than the CVD-negative group (2.06 +/- 0.66 vs. 3.45 +/- 1.75, P < 0.005). The GIR value was also significantly lower in the hypertriglyceridemic group compared with the normotriglyceridemic group (2.50 +/- 1.36 vs. 4.03 +/- 1.82, P < 0.0005). However, there was no significant difference between the hypertensive and normotensive groups and between the high cholesterol or low HDL-cholesterol groups and their respective control groups. In conclusion, these results suggest that IR contributes to the clustering of CVD-RFs which may accelerate the development of CVD in the subgroup of Japanese NIDDM patients.
为研究胰岛素刺激的葡萄糖摄取抵抗（IR）是否与非胰岛素依赖型糖尿病（NIDDM）患者的心血管疾病（CVD）危险因素（RF）相关，我们测定了135例无晚期糖尿病并发症的成年NIDDM患者的IR程度。进行了正常血糖（80mg/dl）高胰岛素钳夹试验（胰岛素输注速率为1.12mU/kg每分钟），并将稳态正常血糖期间的平均葡萄糖输注速率（GIR）作为IR的一项指标。IR增加的NIDDM患者中高血压更为常见，在患有CVD的患者组中最为严重。高血压、高甘油三酯血症、低高密度脂蛋白胆固醇和肥胖等CVD-RF往往聚集在GIR值较低且空腹IRI水平较高的NIDDM患者中。在从135例NIDDM患者中提取的按年龄、性别、体重指数和糖化血红蛋白水平匹配的一组组间比较GIR值。CVD阳性组的GIR值显著低于CVD阴性组（2.06±0.66对3.45±1.75，P<0.005）。高甘油三酯血症组的GIR值也显著低于正常甘油三酯血症组（2.50±1.36对4.03±1.82，P<0.0005）。然而，高血压组与血压正常组之间以及高胆固醇或低高密度脂蛋白胆固醇组与其各自的对照组之间没有显著差异。总之，这些结果表明，IR促成了CVD-RF的聚集，这可能加速日本NIDDM患者亚组中CVD的发展。
