Utriainen T, Takala T, Luotolahti M, Rönnemaa T, Laine H, Ruotsalainen U, Haaparanta M, Nuutila P, Yki-Järvinen H
Turku PET Centre, University of Turku, Finland.
Diabetologia. 1998 May;41(5):555-9. doi: 10.1007/s001250050946.
Skeletal muscle insulin resistance and coronary heart disease (CHD) often precede non-insulin-dependent diabetes mellitus (NIDDM). A recent study showed the myocardium of patients with CHD to be insulin resistant, independent of blood flow. We determined whether myocardial insulin resistance is a feature of NIDDM patients with no CHD. Skeletal muscle and myocardial glucose uptake were determined in 10 patients with NIDDM and 9 age- and weight-matched normal men of similar age and body mass index men using [18F]-2-fluoro-2-deoxy-D-glucose and positron emission tomography under normoglycaemic hyperinsulinaemic conditions. Whole body glucose uptake, as determined by the euglycaemic clamp technique, was significantly lower in the patients with NIDDM (35+/-3 micromol/kg body weight min) than the normal subjects (45+/-3 micromol/kg body weight x min, p < 0.02). Insulin-stimulated femoral muscle glucose uptake was significantly lower in the patients with NIDDM (71+/-6 micromol/kg muscle x min) than in the normal subjects (96+/-5 micromol/kg muscle x min, p < 0.01). Whole body glucose uptake was correlated with femoral muscle glucose uptake in the entire group (r=0.76, p < 0.001), in patients with NIDDM and in normal subjects. Rates of insulin-stimulated myocardial glucose uptake were comparable between the patients with NIDDM (814+/-76 micromol/kg muscle min) and the normal subjects (731+/-63 micromol/kg muscle min, p > 0.4). Whole body or femoral muscle, and myocardial glucose uptake were not correlated in all subjects, patients with NIDDM or normal subjects. We conclude that insulin resistance of the myocardium is not a feature of uncomplicated NIDDM.
骨骼肌胰岛素抵抗和冠心病（CHD）往往先于非胰岛素依赖型糖尿病（NIDDM）出现。最近一项研究表明，冠心病患者的心肌存在胰岛素抵抗，且与血流无关。我们确定心肌胰岛素抵抗是否是非冠心病NIDDM患者的一个特征。在正常血糖高胰岛素血症条件下，使用[18F]-2-氟-2-脱氧-D-葡萄糖和正电子发射断层扫描技术，测定了10例NIDDM患者以及9名年龄和体重匹配、年龄和体重指数相近的正常男性的骨骼肌和心肌葡萄糖摄取情况。通过正常血糖钳夹技术测定的全身葡萄糖摄取量，NIDDM患者（35±3微摩尔/千克体重·分钟）显著低于正常受试者（45±3微摩尔/千克体重·分钟，p<0.02）。NIDDM患者胰岛素刺激的股四头肌葡萄糖摄取量（71±6微摩尔/千克肌肉·分钟）显著低于正常受试者（96±5微摩尔/千克肌肉·分钟，p<0.01）。在整个研究组、NIDDM患者和正常受试者中，全身葡萄糖摄取量与股四头肌葡萄糖摄取量相关（r = 0.76，p<0.001）。NIDDM患者（814±76微摩尔/千克肌肉·分钟）和正常受试者（731±63微摩尔/千克肌肉·分钟，p>0.4）胰岛素刺激的心肌葡萄糖摄取率相当。在所有受试者、NIDDM患者或正常受试者中，全身或股四头肌以及心肌葡萄糖摄取量均无相关性。我们得出结论，心肌胰岛素抵抗不是单纯NIDDM的特征。
