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首页> 外文期刊>American Journal of Physiology >The effect of insulin on net lipid oxidation predicts worsening of insulin resistance and development of type 2 diabetes mellitus.
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The effect of insulin on net lipid oxidation predicts worsening of insulin resistance and development of type 2 diabetes mellitus.

机译：胰岛素对净脂质氧化的影响预示着胰岛素抵抗的恶化和2型糖尿病的发展。

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Suppression of lipid oxidation (L(ox)) by insulin is impaired in obesity and type 2 diabetes mellitus (T2DM). Here we tested whether high L(ox) represents a primary or acquired characteristic in the pathogenesis of T2DM. Hood-indirect calorimetry was performed under postabsorptive conditions and during a two-step hyperinsulinemic euglycemic clamp (insulin infusion rates in mU.m(-2).min(-1): 40 low and 400 high) in 465 Pima Indians: 317 with normal glucose tolerance (NGT), 117 with impaired glucose tolerance (IGT), and 31 with T2DM. The predictive effect of net lipid oxidation (L(ox)) on development of T2DM was assessed in 296 subjects (51 of whom developed T2DM), whereas the predictive effect of L(ox) on followup changes in insulin-mediated glucose disposal (M) and acute insulin response (AIR) was studied in 190 subjects with NGT at baseline. Cross-sectionally, after adjustment for age, sex, body fat (BF), and M low, L(ox) low was increased in T2DM compared with NGT and IGT subjects (P < 0.05). Prospectively, after adjustment for followup duration, age, sex, BF, M, and AIR, increased clamp L(ox) predicted T2DM [hazard rate ratios (95% CI): L(ox) low, 1.5 (1.1, 2.0), P < 0.01; L(ox) high, 1.3 (1.0, 1.8), P = 0.05]. High L(ox) low at baseline was also associated with subsequent worsening of M low (P = 0.04). These data indicate that the inability of insulin to suppress L(ox) may represent an early risk marker for insulin resistance and T2DM that is independent of adiposity, acute insulin secretion, and insulin action on glucose uptake.
机译：在肥胖和2型糖尿病（T2DM）中，胰岛素对脂质氧化（L（ox））的抑制作用减弱。在这里，我们测试了高L（ox）代表T2DM发病机理中的主要特征还是获得性特征。在吸收后的条件下，在两步高胰岛素正常血糖钳制过程中（在mU.m（-2）.min（-1）中的胰岛素输注速率：40低和400高）中进行罩式间接量热法。正常的葡萄糖耐量（NGT），117的葡萄糖耐量（IGT）受损和31的T2DM。在296名受试者（其中51名已发展为T2DM）中评估了净脂质氧化（L（ox））对T2DM发育的预测作用，而L（ox）对胰岛素介导的葡萄糖处置后续变化的预测作用（M ），并在基线的190名NGT患者中研究了急性胰岛素反应（AIR）。横断面，与NGT和IGT受试者相比，在调整了年龄，性别，体脂（BF）和M低后，T2DM中L（ox）低升高了（P <0.05）。预期地，在对随访时间，年龄，性别，BF，M和AIR进行调整之后，增加钳位L（ox）预测的T2DM [危险率（95％CI）：L（ox）低1.5（1.1，2.0）， P <0.01; L（ox）高1.3（1.0，1.8），P = 0.05]。基线时高的L（ox）低也与随后的M低恶化有关（P = 0.04）。这些数据表明，胰岛素不能抑制L（ox）可能代表了胰岛素抵抗和T2DM的早期危险标志物，与肥胖，急性胰岛素分泌和胰岛素对葡萄糖摄取的作用无关。

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