Paolisso G, Tataranni P A, Foley J E, Bogardus C, Howard B V, Ravussin E
Clinical Diabetes and Nutrition Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona 85016, USA.
Diabetologia. 1995 Oct;38(10):1213-7. doi: 10.1007/BF00422371.
To assess the role of fasting plasma non-esterified fatty acids (NEFA) in the development of non-insulin-dependent diabetes mellitus (NIDDM), data were analysed from annual examinations of 190 non-diabetic Pima Indians. Glucose tolerance was measured by a 75-g oral glucose tolerance test, insulin action by a euglycaemic hyperinsulinaemic (40 mU x m-2 x min-1) clamp and in vitro lipolysis using isolated abdominal fat cells. After a mean follow-up period of 4.0 +/- 2.4 years (mean +/- SD), 47 subjects developed NIDDM. Risk factors for NIDDM were estimated by proportional-hazards analysis and risk ratios (RR) with 95% confidence intervals (95% CI) calculated at the 90th and 10th percentile of the predictor variables. A large average fat-cell volume was predictive of NIDDM (RR=2.4; 95% CI=1.2-4.8) independent of age, sex, percent body and body fat distribution. A high fasting plasma NEFA concentration was also a risk factor for NIDDM (RR=2.3; 95% CI=1.1-4.7) independent of sex, percent body fat, waist/thigh ratio, insulin-mediated glucose uptake and fasting triglyceride concentration. We conclude that large fat cells and the resulting increased plasma NEFA concentrations are risk factors for the development of NIDDM.
为评估空腹血浆非酯化脂肪酸（NEFA）在非胰岛素依赖型糖尿病（NIDDM）发生发展中的作用，我们分析了190名非糖尿病皮马印第安人年度检查的数据。通过75克口服葡萄糖耐量试验测量葡萄糖耐量，通过正常血糖高胰岛素血症（40 mU·m⁻²·min⁻¹）钳夹测量胰岛素作用，并使用分离的腹部脂肪细胞进行体外脂肪分解测定。在平均随访4.0±2.4年（平均值±标准差）后，47名受试者患上了NIDDM。通过比例风险分析估计NIDDM的危险因素，并在预测变量的第90和第10百分位数处计算风险比（RR）及95%置信区间（95%CI）。平均脂肪细胞体积大是NIDDM的预测因素（RR = 2.4；95%CI = 1.2 - 4.8），与年龄、性别、身体百分比和体脂分布无关。空腹血浆NEFA浓度高也是NIDDM的危险因素（RR = 2.3；95%CI = 1.1 - 4.7），与性别、体脂百分比、腰臀比、胰岛素介导的葡萄糖摄取和空腹甘油三酯浓度无关。我们得出结论，大脂肪细胞以及由此导致的血浆NEFA浓度升高是NIDDM发生发展的危险因素。
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