Ezenwaka C E, Akanji A O, Osei K, Adejuwon C A, O'Dorisio T M, Cottrell D A, Akinlade K S
Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria.
Diabetes Res Clin Pract. 1993 Jun;20(3):175-81. doi: 10.1016/0168-8227(93)90075-g.
We analysed blood insulin and glucose concentrations before and during frequently sampled intravenous glucose tolerance tests (FSIGT) in 2 groups of Nigerian subjects: (A) Control group (n = 18), without a positive family history of diabetes mellitus, and (B) Experimental group (n = 16), comprising age-, sex- and body mass-matched first-degree relatives of patients with non-insulin-dependent diabetes mellitus (NIDDM). In comparison with Group A subjects, those in Group B had: (i) higher fasting plasma glucose level (mean +/- S.E.M. 4.1 +/- 0.1 vs. 3.8 +/- 0.11 mmol/l, P < 0.05); (ii) similar fasting serum insulin levels (6.7 +/- 5.0 vs. 5.8 +/- 5.6 mU/l, P = NS); (iii) lower mean incremental area under the first-phase (t = 0-10 min) post-glucose challenge insulin curve (376.9 +/- 8.8 vs. 435.6 +/- 5.6 mU/min l-1, P < 0.05); (iv) increased incremental area under the second-phase (t = 10-182 min) post-glucose challenge insulin curve (432.9 +/- 11.5 vs. 161.3 +/- 8.7 mU/min l-1, P < 0.05); (v) reduced KG rate constant of glucose elimination (0.97 +/- 0.12 vs. 1.41 +/- 0.12%/min, P < 0.05). These results suggest that the subjects with a positive family history of NIDDM have a reduced beta-cell insulin secretory reserve (from reduced first-phase insulin response), tendency to rebound hyperinsulinemia during the latter phase of the insulin secretory response, a degree of tissue insulin insensitivity (as evident from high fasting plasma glucose despite similar insulin levels) and a diminished glucose disposal rate, in comparison with subjects without a family history of NIDDM. These features predict subsequent development of diabetes and suggest that as in Caucasians, first-degree relatives of Nigerian patients with NIDDM are at greater risk for future development of the disease.
我们分析了两组尼日利亚受试者在频繁采样静脉葡萄糖耐量试验（FSIGT）之前及期间的血液胰岛素和葡萄糖浓度：（A）对照组（n = 18），无糖尿病家族史；（B）实验组（n = 16），由非胰岛素依赖型糖尿病（NIDDM）患者的年龄、性别和体重匹配的一级亲属组成。与A组受试者相比，B组受试者有：（i）更高的空腹血糖水平（均值±标准误 4.1±0.1 与 3.8±0.11 mmol/l，P < 0.05）；（ii）相似的空腹血清胰岛素水平（6.7±5.0 与 5.8±5.6 mU/l，P = 无显著差异）；（iii）葡萄糖激发后第一阶段（t = 0 - 10分钟）胰岛素曲线下平均增加面积较低（376.9±8.8 与 435.6±5.6 mU/min·l-1，P < 0.05）；（iv）葡萄糖激发后第二阶段（t = 10 - 182分钟）胰岛素曲线下增加面积增加（432.9±11.5 与 161.3±8.7 mU/min·l-1，P < 0.05）；（v）葡萄糖清除的KG速率常数降低（0.97±0.12 与 1.41±0.12%/分钟，P < 0.05）。这些结果表明，与无NIDDM家族史的受试者相比，有NIDDM家族史的受试者具有降低的β细胞胰岛素分泌储备（因第一阶段胰岛素反应降低）、胰岛素分泌反应后期出现反弹性高胰岛素血症的倾向、一定程度的组织胰岛素不敏感性（尽管胰岛素水平相似，但空腹血糖高可证明）以及葡萄糖处置率降低。这些特征预示着随后糖尿病的发生，并表明与高加索人一样，尼日利亚NIDDM患者的一级亲属未来患该病的风险更大。
