Chaiken R L, Banerji M A, Huey H, Lebovitz H E
Department of Medicine, State University of New York-Health Science Center at Brooklyn, Brooklyn 11203.
Diabetes. 1993 Mar;42(3):444-9. doi: 10.2337/diab.42.3.444.
NIDDM has been postulated to be a component of a more generalized metabolic syndrome, Syndrome X, caused by insulin resistance. Although the components of the syndrome include glucose intolerance, hypertension, increased TG, and decreased HDL cholesterol, their relationship to insulin resistance and/or hyperinsulinemia is controversial. Recent investigations have shown racial differences in the relationship between insulin resistance and BP in nondiabetic populations. We assessed the relationship between insulin resistance and the other components of the syndrome in 37 black men and 53 black women with NIDDM. Insulin sensitivity was determined by measuring glucose disposal with the euglycemic insulin clamp technique with a 1 mU.kg-1.min-1 insulin infusion. We also determined fasting lipid profiles and BP. In this group of black men and women with NIDDM, 30% were insulin sensitive, and 70% were insulin resistant. No correlation existed between insulin sensitivity and sBP or dBP in either sex. Fasting serum TGs were inversely correlated with insulin sensitivity for both men (r = -0.401, P = 0.02) and women (r = -0.366, P = 0.008). Serum HDL cholesterol was highly correlated with insulin sensitivity for men (r = 0.421, P = 0.01) but not for women (r = 0.071, P = 0.62). Fasting serum TG levels and serum HDL-cholesterol levels were highly correlated in an inverse relationship in men (r = -0.368, P = 0.03), but not women (r = -0.199, P = 0.17). In summary, BP does not correlate with insulin resistance in blacks with NIDDM. Normal insulin sensitivity occurs in 33% of black men and 25% of black women with NIDDM.(ABSTRACT TRUNCATED AT 250 WORDS)
非胰岛素依赖型糖尿病（NIDDM）被认为是由胰岛素抵抗引起的更广泛的代谢综合征（X综合征）的一个组成部分。尽管该综合征的组成部分包括葡萄糖耐量异常、高血压、甘油三酯（TG）升高和高密度脂蛋白（HDL）胆固醇降低，但其与胰岛素抵抗和/或高胰岛素血症的关系仍存在争议。最近的研究表明，非糖尿病人群中胰岛素抵抗与血压之间的关系存在种族差异。我们评估了37名患有NIDDM的黑人男性和53名患有NIDDM的黑人女性中胰岛素抵抗与该综合征其他组成部分之间的关系。通过使用1 mU.kg-1.min-1胰岛素输注的正常血糖胰岛素钳夹技术测量葡萄糖代谢来确定胰岛素敏感性。我们还测定了空腹血脂谱和血压。在这组患有NIDDM的黑人男性和女性中，30%胰岛素敏感，70%胰岛素抵抗。无论男性还是女性，胰岛素敏感性与收缩压（sBP）或舒张压（dBP）均无相关性。空腹血清TG与男性（r = -0.401，P = 0.02）和女性（r = -0.366，P = 0.008）的胰岛素敏感性呈负相关。血清HDL胆固醇与男性的胰岛素敏感性高度相关（r = 0.421，P = 0.01），但与女性无关（r = 0.071，P = 0.62）。男性空腹血清TG水平与血清HDL胆固醇水平呈高度负相关（r = -0.368，P = 0.03），但女性并非如此（r = -0.199，P = 0.17）。总之，患有NIDDM的黑人中血压与胰岛素抵抗无关。33%的患有NIDDM的黑人男性和25%的患有NIDDM的黑人女性存在正常的胰岛素敏感性。（摘要截短于250字）
