Haffner S M, Miettinen H, Stern M P
Department of Medicine, University of Texas Health Science Center at San Antonio, TX 78284-7873, USA.
Diabetes Care. 1996 Jan;19(1):67-9. doi: 10.2337/diacare.19.1.67.
To study why Mexican-Americans have a threefold increase in NIDDM relative to non-Hispanic whites. The etiology of NIDDM is still controversial, with both insulin resistance and decreased insulin secretion proposed as precursors of NIDDM.
We examined possible ethnic differences in fasting insulin (as a marker of insulin resistance) and change in insulin-to-change in glucose ratio (delta I30:delta G30) during the first 30 min after oral glucose ingestion (as a marker of abnormal whites from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Fasting insulin and delta I30:delta G30 were evaluated as continuous variables.
Mexican-Americans had increased insulin concentrations at fasting and 30, 60, and 120 min after an oral glucose load as well as an increased 0- to 30-min increment in insulin and delta I30:delta G30 relative to non-Hispanic whites. These results remained unchanged after adjustment for age, sex, obesity, body fat distribution, and glucose tolerance.
These results suggest that increased insulin resistance rather than decreased insulin secretion is characteristic of nondiabetic Mexican-Americans, a high-risk population for NIDDM.
研究墨西哥裔美国人患非胰岛素依赖型糖尿病（NIDDM）的几率相对于非西班牙裔白人为何高出两倍。NIDDM的病因仍存在争议，胰岛素抵抗和胰岛素分泌减少均被认为是NIDDM的先兆。
我们在口服葡萄糖后的最初30分钟内，检测了空腹胰岛素（作为胰岛素抵抗的指标）以及胰岛素与葡萄糖变化比值的变化（δI30:δG30）（作为胰岛素分泌异常的指标）在墨西哥裔美国人和非西班牙裔白人之间可能存在的种族差异。这些数据来自圣安东尼奥心脏研究，这是一项基于人群的糖尿病和心血管疾病研究。空腹胰岛素和δI30:δG30作为连续变量进行评估。
与非西班牙裔白人相比，墨西哥裔美国人在口服葡萄糖负荷后空腹、30分钟、60分钟和120分钟时的胰岛素浓度升高，同时胰岛素在0至30分钟内的增量以及δI30:δG30也增加。在对年龄、性别、肥胖、体脂分布和糖耐量进行调整后，这些结果保持不变。
这些结果表明，胰岛素抵抗增加而非胰岛素分泌减少是未患糖尿病的墨西哥裔美国人的特征，该群体是患NIDDM的高危人群。
