Kohrt W M, Kirwan J P, Staten M A, Bourey R E, King D S, Holloszy J O
Washington University School of Medicine, Department of Medicine, St. Louis, MO 63110.
Diabetes. 1993 Feb;42(2):273-81.
Studies have shown that insulin resistance increases with age, independent of changes in total adiposity. However, there is growing evidence that the development of insulin resistance may be more closely related to abdominal adiposity. To evaluate the independent effects of aging and regional and total adiposity on insulin resistance, we performed hyperinsulinemic euglycemic clamps on 17 young (21-33 yr) and 67 older (60-72 yr) men and women. We assessed FFM and total and regional adiposity by hydrodensitometry and anthropometry. Insulin-stimulated GDRs at a plasma insulin concentration of approximately 450 pM averaged 45.6 +/- 3.3 mumol.kg FFM-1 x min-1 (mean +/- SE) in the young subjects, 45.6 +/- 10.0 mumol.kg FFM-1 x min-1 in 24 older subjects who were insulin sensitive, and 23.9 +/- 11.7 mumol.kg FFM-1 x min-1 in 43 older subjects who were insulin resistant. Few significant differences were apparent in skin-fold and circumference measurements between young and insulin-sensitive older subjects, but measurements at most central body sites were significantly larger in the insulin-resistant older subjects. Waist girth accounted for > 40% of the variance in insulin action, whereas age explained only 10-20% of the total variance and < 2% of the variance when the effects of waist circumference were statistically controlled. These results suggest that insulin resistance is more closely associated with abdominal adiposity than with age.
研究表明，胰岛素抵抗随年龄增长而增加，与总体脂变化无关。然而，越来越多的证据表明，胰岛素抵抗的发展可能与腹部肥胖关系更为密切。为了评估衰老、局部和总体脂对胰岛素抵抗的独立影响，我们对17名年轻（21 - 33岁）和67名年长（60 - 72岁）的男性和女性进行了高胰岛素正常血糖钳夹试验。我们通过水下密度测定法和人体测量法评估了去脂体重、总体脂和局部脂肪。在血浆胰岛素浓度约为450 pM时，年轻受试者胰岛素刺激的葡萄糖处置率（GDRs）平均为45.6±3.3 μmol·kg去脂体重⁻¹·min⁻¹（均值±标准误），24名胰岛素敏感的年长受试者为45.6±10.0 μmol·kg去脂体重⁻¹·min⁻¹，43名胰岛素抵抗的年长受试者为23.9±11.7 μmol·kg去脂体重⁻¹·min⁻¹。年轻和胰岛素敏感的年长受试者在皮褶厚度和周长测量方面几乎没有明显差异，但在大多数身体中心部位的测量中，胰岛素抵抗的年长受试者明显更大。腰围占胰岛素作用差异的40%以上，而年龄仅解释了总差异的10 - 20%，在对腰围的影响进行统计学控制后，年龄解释的差异小于2%。这些结果表明，胰岛素抵抗与腹部肥胖的关系比与年龄的关系更为密切。
