Jeng C Y, Sheu W H, Fuh M M, Chen Y D, Reaven G M
Division of Endocrinology and Metabolism, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Diabetes. 1994 Dec;43(12):1440-4. doi: 10.2337/diab.43.12.1440.
This study was initiated to reevaluate the changes in basal hepatic glucose production (HGP) rate that occur in patients with non-insulin-dependent diabetes mellitus (NIDDM). Measurements were made in 51 volunteers: 18 with normal glucose tolerance and 33 with newly diagnosed NIDDM of varying degrees of severity. To avoid the methodological problems associated with quantifying HGP over short time periods, using non-steady-state isotopic kinetics, radiolabeled glucose was infused for a 12-h period, from 10 P.M. to 10 A.M. with HGP quantified from 9 to 10 A.M.. The results showed that fasting plasma glucose (FPG) concentration and HGP were significantly correlated (r = 0.68, P < 0.001) in patients with NIDDM. However, when the 33 patients with NIDDM were divided into three groups of 11 each on the basis of FPG concentration, it became clear that the relationship between FPG and HGP was complex. Thus, values for HGP in patients with NIDDM and FPG < 180 mg/dl were not higher than in the normal population (1.67 +/- 0.07 vs. 1.69 +/- 0.04 mg.kg-1.min-1, NS). Significant increases (P < 0.01) in HGP above normal were seen in the 11 patients with NIDDM and FPG concentrations between 180 and 250 mg/dl (2.05 +/- 0.07 mg.kg-1.min-1), as well as in those with FPG > 250 mg/dl (2.18 +/- 0.13 mg.kg-1.min-1). Although those with the highest FPG concentrations tended to have the greatest values for HGP, the difference between the latter two groups of patients with NIDDM was not statistically significant. Finally, HGP rates in the 11 patients with FPG concentrations > 250 mg/dl were only 29% higher than values in the control population.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在重新评估非胰岛素依赖型糖尿病（NIDDM）患者基础肝葡萄糖生成（HGP）率的变化。对51名志愿者进行了测量：18名糖耐量正常者和33名新诊断的不同严重程度的NIDDM患者。为避免与使用非稳态同位素动力学在短时间内量化HGP相关的方法学问题，从晚上10点至上午10点输注放射性标记葡萄糖12小时，从上午9点至10点对HGP进行量化。结果显示，NIDDM患者的空腹血糖（FPG）浓度与HGP显著相关（r = 0.68，P < 0.001）。然而，当根据FPG浓度将33名NIDDM患者分为三组，每组11人时，很明显FPG与HGP之间的关系很复杂。因此，FPG < 180 mg/dl的NIDDM患者的HGP值并不高于正常人群（1.67 +/- 0.07 vs. 1.69 +/- 0.04 mg·kg-1·min-1，无显著性差异）。FPG浓度在180至250 mg/dl之间的11名NIDDM患者以及FPG > 250 mg/dl的患者中，HGP显著高于正常水平（P < 0.01）（分别为2.05 +/- 0.07 mg·kg-1·min-1和2.18 +/- 0.13 mg·kg-1·min-1）。尽管FPG浓度最高的患者往往HGP值最大，但后两组NIDDM患者之间的差异无统计学意义。最后，FPG浓度> 250 mg/dl的11名患者的HGP率仅比对照组人群的值高29%。（摘要截选至250字）
