Ebeling P, Essén-Gustavsson B, Tuominen J A, Koivisto V A
Department of Medicine, University of Helsinki, Finland.
Diabetologia. 1998 Jan;41(1):111-5. doi: 10.1007/s001250050875.
Increased lipid oxidation is related to insulin resistance. Some of the enhanced lipid utilization may be derived from intramuscular sources. We studied muscle triglyceride (mTG) concentration and its relationship to insulin sensitivity in 10 healthy men (age 29 +/- 2 years, BMI 23.3 +/- 0.6 kg/m2) and 17 men with insulin-dependent diabetes mellitus (IDDM) (age 30 +/- 2 years, BMI 22.8 +/- 0.5 kg/m2, diabetes duration 14 +/- 2 years, HbA1c 7.7 +/- 0.3%, insulin dose 48 +/- 3 U/day). Insulin sensitivity was measured with a 4h euglycaemic (5 mmol/l) hyperinsulinaemic (1.5 mU or 9 pmol x kg(-1) x min[-1]) clamp accompanied by indirect calorimetry before and at the end of the insulin infusion. A percutaneous biopsy was performed from m. vastus lateralis for the determination of mTG. At baseline the IDDM patients had higher glucose (10.2 +/- 0.9 vs 5.6 +/- 0.1 mmol/l, p < 0.001), insulin (40.3 +/- 3.2 vs 23.2 +/- 4.2 pmol/l, p < 0.01), HDL cholesterol (1.28 +/- 0.06 vs 1.04 +/- 0.03 mmol/l, p < 0.01) and mTG (32.9 +/- 4.6 vs 13.6 +/- 2.7 mmol/kg dry weight, p < 0.01) concentrations than the healthy men, respectively. The IDDM patients had lower insulin stimulated whole body total (-25%, p < 0.001), oxidative (-18%, p < 0.01) and non-oxidative glucose disposal rates (-43%, p < 0.001), whereas lipid oxidation rate was higher in the basal state (+ 44%, p < 0.01) and during hyperinsulinaemia (+283%, p < 0.05). mTG concentrations did not change significantly during the clamp or correlate with insulin stimulated glucose disposal. In healthy men mTG correlated positively with lipid oxidation rate at the end of hyperinsulinaemia (r = 0.75, p < 0.05).
脂质氧化增加与胰岛素抵抗有关。部分增强的脂质利用可能源自肌肉内源性。我们研究了10名健康男性（年龄29±2岁，体重指数23.3±0.6kg/m²）和17名胰岛素依赖型糖尿病（IDDM）男性患者（年龄30±2岁，体重指数22.8±0.5kg/m²，糖尿病病程14±2年，糖化血红蛋白7.7±0.3%，胰岛素剂量48±3U/天）的肌肉甘油三酯（mTG）浓度及其与胰岛素敏感性的关系。在胰岛素输注前及输注结束时，通过4小时正常血糖（5mmol/l）高胰岛素血症（1.5mU或9pmol·kg⁻¹·min⁻¹）钳夹并伴有间接测热法来测量胰岛素敏感性。从股外侧肌进行经皮活检以测定mTG。基线时，IDDM患者的血糖（10.2±0.9 vs 5.6±0.1mmol/l，p<0.001）、胰岛素（40.3±3.2 vs 23.2±4.2pmol/l，p<0.01）、高密度脂蛋白胆固醇（1.28±0.06 vs 1.04±0.03mmol/l，p<0.01）和mTG（32.9±4.6 vs 13.6±2.7mmol/kg干重，p<0.01）浓度均分别高于健康男性。IDDM患者胰岛素刺激的全身总葡萄糖处置率（-25%，p<）、氧化葡萄糖处置率（-18%，p<0.01）和非氧化葡萄糖处置率（-43%，p<0.001）较低，而基础状态下脂质氧化率较高（+44%，p<0.01）且高胰岛素血症期间更高（+283%，p<0.05）。钳夹期间mTG浓度无显著变化，且与胰岛素刺激的葡萄糖处置无相关性。在健康男性中，高胰岛素血症结束时mTG与脂质氧化率呈正相关（r=0.75，p<0.05）。
1）IDDM与肌肉内甘油三酯含量增加有关。2）在健康受试者或IDDM患者中，mTG含量与胰岛素敏感性无关。
