当前位置: X-MOL 学术Diabetol. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Mechanisms of hyperinsulinaemia in apparently healthy non-obese young adults: role of insulin secretion, clearance and action and associations with plasma amino acids.
Diabetologia ( IF 8.2 ) Pub Date : 2019-09-06 , DOI: 10.1007/s00125-019-04990-y
Steven Hamley 1 , Danielle Kloosterman 1 , Tamara Duthie 1 , Chiara Dalla Man 2 , Roberto Visentin 2 , Shaun A Mason 1 , Teddy Ang 1 , Ahrathy Selathurai 1 , Gunveen Kaur 1 , Maria G Morales-Scholz 1 , Kirsten F Howlett 1 , Greg M Kowalski 1 , Christopher S Shaw 1 , Clinton R Bruce 1
Affiliation  

AIMS/HYPOTHESIS This study aimed to examine the metabolic health of young apparently healthy non-obese adults to better understand mechanisms of hyperinsulinaemia. METHODS Non-obese (BMI < 30 kg/m2) adults aged 18-35 years (N = 254) underwent a stable isotope-labelled OGTT. Insulin sensitivity, glucose effectiveness and beta cell function were determined using oral minimal models. Individuals were stratified into quartiles based on their insulin response during the OGTT, with quartile 1 having the lowest and quartile 4 the highest responses. RESULTS Thirteen per cent of individuals had impaired fasting glucose (IFG; n = 14) or impaired glucose tolerance (IGT; n = 19), allowing comparisons across the continuum of insulin responses within the spectrum of normoglycaemia and prediabetes. BMI (~24 kg/m2) was similar across insulin quartiles and in those with IFG and IGT. Despite similar glycaemic excursions, fasting insulin, triacylglycerols and cholesterol were elevated in quartile 4. Insulin sensitivity was lowest in quartile 4, and accompanied by increased insulin secretion and reduced insulin clearance. Individuals with IFG had similar insulin sensitivity and beta cell function to those in quartiles 2 and 3, but were more insulin sensitive than individuals in quartile 4. While individuals with IGT had a similar degree of insulin resistance to quartile 4, they exhibited a more severe defect in beta cell function. Plasma branched-chain amino acids were not elevated in quartile 4, IFG or IGT. CONCLUSIONS/INTERPRETATION Hyperinsulinaemia within normoglycaemic young, non-obese adults manifests due to increased insulin secretion and reduced insulin clearance. Individual phenotypic characterisation revealed that the most hyperinsulinaemic were more similar to individuals with IGT than IFG, suggesting that hyperinsulinaemic individuals may be on the continuum toward IGT. Furthermore, plasma branched-chain amino acids may not be an effective biomarker in identifying hyperinsulinaemia and insulin resistance in young non-obese adults.

中文翻译:

在显然健康的非肥胖年轻人中高胰岛素血症的机制:胰岛素分泌,清除和作用的作用以及与血浆氨基酸的关系。

目的/假设这项研究旨在检查貌似健康的年轻非肥胖成年人的代谢健康状况,以更好地了解高胰岛素血症的机制。方法对年龄在18-35岁(N = 254)的非肥胖(BMI <30 kg / m2)成年人进行稳定的同位素标记OGTT。使用口服最小模型测定胰岛素敏感性,葡萄糖有效性和β细胞功能。根据他们在OGTT期间的胰岛素反应将其分为四分位数,四分位数1的响应最低,四分位数4的响应最高。结果13%的人的空腹血糖受损(IFG; n = 14)或葡萄糖耐量受损(IGT; n = 19),可以在正常血糖和糖尿病前期人群中连续进行胰岛素反应的比较。胰岛素四分位数与IFG和IGT患者的BMI(〜24 kg / m2)相似。尽管血糖波动相似,但四分位数4的空腹胰岛素,三酰甘油和胆固醇升高。四分位数4的胰岛素敏感性最低,并伴有胰岛素分泌增加和胰岛素清除率降低。IFG个体的胰岛素敏感性和β细胞功能与四分位数2和3相似,但对胰岛素的敏感性比四分位数4的个体更高。尽管IGT个体对四分位数4的胰岛素抵抗程度相似,但他们表现出更为严重的症状β细胞功能缺陷。四分位数4,IFG或IGT中血浆支链氨基酸未升高。结论/解释血糖正常的年轻高胰岛素血症,非肥胖成年人表现为胰岛素分泌增加和胰岛素清除率降低。个体的表型特征显示,与IGG相比,大多数高胰岛素血症患者与IGT个体更相似,这表明高胰岛素血症个体可能处于朝向IGT的连续体上。此外,血浆支链氨基酸可能不是识别年轻非肥胖成年人中高胰岛素血症和胰岛素抵抗的有效生物标志物。
更新日期:2019-09-06
down
wechat
bug