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目的 应用扩展高胰岛素 正葡萄糖钳夹技术 ,研究正常糖耐量中国人中正常体重者及超重 /肥胖者胰岛素敏感性的异同 ,以及体脂含量及分布与胰岛素敏感性的关系。方法 对 2 2例居住上海地区中国人 ,其中正常体重组 (BMI <2 5kg/m2 ) 9例 ,超重 /肥胖组 (BMI≥ 2 5kg/m2 ) 13例 ,进行扩展高胰岛素 正葡萄糖钳夹试验 ,并应用核磁共振技术 (MRI)测定局部体脂。结果 (1)超重 /肥胖组较之正常体重组胰岛素介导的葡萄糖利用率降低〔(3 .37± 0 .15 )mg·kg-1·min-1比 (5 .86± 0 .6 5 )mg·kg-1·min-1,P <0 .0 1〕 ,以糖原合成障碍为主〔(1.5 1± 0 .15 )mg·kg-1·min-1比 (3.17± 0 .6 2 )mg·kg-1·min-1,P <0 .0 1〕。 (2 )超重 /肥胖组胰岛素抑制脂氧化及血游离脂肪酸水平的作用减弱。(3)局部体脂中以腹内脂肪增加对胰岛素敏感性的影响最显著 (r =- 0 .80 ,P <0 .0 1)。结论中国人正常糖耐量、超重 /肥胖个体胰岛素敏感性下降 ,腹内脂肪增加是胰岛素抵抗的主要原因
OBJECTIVE: To explore the similarities and differences of insulin sensitivity in normal glucose tolerance Chinese with normal weight and overweight / obesity, and to explore the relationship between body fat content and insulin secretion and insulin sensitivity using extended hyperinsulinemic positive glucose clamp technique. Methods Twenty-two Chinese living in Shanghai, including 9 normal weight group (BMI <25kg / m2) and 13 hypertensive / obesity group (BMI≥25kg / m2) , And the application of nuclear magnetic resonance (MRI) determination of body fat. Results (1) Insulin-mediated glucose utilization in overweight / obesity group was lower than that in normal weight group [(3.37 ± 0.15) mg · kg -1 · min -1 (5.86 ± 0.56 ) mg · kg-1 · min-1, P <0.01), with predominant glycogen synthesis [(1.51 ± 0.155) mg · kg-1 · min-1 vs (3.17 ± 0) 6 2) mg · kg -1 · min-1, P <0.01). (2) Insulin in overweight / obesity group inhibited the effect of lipid oxidation and blood free fatty acid levels. (3) The increase of intra-abdominal fat in local body fat had the most significant effect on insulin sensitivity (r = - 0.80, P <0.01). Conclusion Chinese people with normal glucose tolerance, insulin sensitivity in overweight / obese individuals decline, and intra-abdominal fat increase is the main reason of insulin resistance