Increasing insulin resistance contributes to worsening glycaemic and lipid profiles in older Chinese subjects

OBJECTIVE: To investigate the impact of insulin resistance on cardiovascular risk factors in the elderly. RESEARCH DESIGN AND METHODS: A cross-sectional, community-based study of 225 older Chinese participants (65-74 years, 55.6% female) recruited from community centres for the elderly in Shatin. Anthropometric measures and DXA body fat, blood pressure, insulin sensitivity (fasting insulin, fasting insulin-glucose product, short insulin tolerance test (SITT)), glycaemic (fasting glucose, glycated haemoglobin A1c) and lipid (total, HDL-, and LDL-cholesterol, triglycerides) indices and albuminuria (24h albumin-to-creatinine ratio) were measured. RESULTS: There was a close correlation between the SITT and insulin-glucose product indices of insulin resistance. Decreasing tertiles of insulin sensitivity were associated with increasing indices of glycaemic control, and general and central obesity, including DXA lean and fat mass, albuminuria, and triglycerides, with decreasing HDL-cholesterol. There were no differences in blood pressure or electrolyte levels between these tertile groups. These subjects were more insulin resistant than a group of younger diabetics. CONCLUSIONS: Insulin resistance was associated with indices of obesity and an atherogenic lipid and hyperglycaemic profile and may in part contribute to the high frequency of metabolic syndrome components in these older Chinese subjects.     

Chromium picolinate for insulin resistance in subjects with HIV disease: a pilot study

Aim:  Multidrug regimens in HIV disease are associated with an increased incidence of insulin resistance, by as much as 50%. Not only does insulin resistance predisposes subjects to diabetes but also it is associated with the metabolic syndrome and increased risk of cardiovascular disease. Previous studies suggest that chromium picolinate can improve insulin resistance in patients with type 2 diabetes. The objective was to study the efficacy and safety of chromium picolinate as a treatment of insulin resistance in subjects infected with HIV.
Methods:  The ability of chromium picolinate (1000 μg/day) to improve insulin sensitivity, determined with a hyperinsulinaemic–euglycaemic insulin clamp, was determined in eight HIV-positive subjects on highly active antiretroviral therapy.
Results:  The mean rate of glucose disposal during the clamp was 4.41 mg glucose/kg lean body mass (LBM)/min (range 2.67–5.50), which increased to 6.51 mg/kg LBM/min (range 3.19–12.78, p = .03), an increase of 25% after 8 weeks of treatment with chromium picolinate. There were no significant changes in blood parameters, HIV viral burden or CD4+ lymphocytes with chromium picolinate treatment. Two subjects experienced abnormalities of liver function during the study. Another subject experienced an elevation in blood urea nitrogen.
Conclusions:  The study shows that chromium picolinate therapy improves insulin resistance in some HIV-positive subjects, but with some concerns about safety in this population.     

非酒精性脂肪肝患者瘦素抵抗和胰岛素抵抗研究

为了研究非酒精性脂肪肝(NAFL)患者的瘦素(Leptin)抵抗和胰岛素抵抗的状况，对40例NAFL患者和30例正常对照组的血清瘦素、胰岛素等水平进行了分析研究，现将结果报道如下。     

Adipose tissue compartments and insulin resistance in overweight-obese Caucasian men

We examined the association between insulin resistance and adipose tissue compartments in overweight/obese men. Total intra-abdominal, intraperitoneal, retroperitoneal, total subcutaneous, anterior subcutaneous and posterior subcutaneous abdominal adipose tissue (PSAAT) masses (total intra-abdominal fat TIAATM, IPATM, RPATM, TSAATM, ASAATM and PSAATM, respectively) were quantified in 51 overweight/obese men using magnetic resonance imaging (MRI). Total adipose tissue mass (TATM) was also determined using bioelectrical impedance. Insulin resistance was estimated by homeostasis model assessment (HOMA) score. In univariate regression analysis, all fat compartments, with the exception of RPATM, were significantly and positively correlated with the HOMA score. The positive correlation between HOMA score and both IPATM and anterior subcutaneous adipose tissue mass was independent of obesity status. After adjusting total for TATM, only IPATM was significantly correlated with HOMA score (partial r=0.38, P<0.01). In stepwise regression, IPATM was the best predictor of HOMA score. In multivariate regression models including age, obesity status, non-esterified fatty acid (NEFAs) levels, triglycerides and energy expenditure, IPATM remained a significant positive predictor (P<0.05) of HOMA score. In overweight/obese men intraperitoneal AT is the fat compartment that best predicts the degree of insulin resistance. This association appears to be independent of age, total body fat mass and obesity status.     

Reduced adipocyte insulin sensitivity in Caucasian and Asian subjects with coronary heart disease

The association between insulin resistance and coronary heart disease (CHD) is strong in the British Indian-Asian population. Adipocyte metabolism may contribute to both insulin resistance and CHD. We examined insulin-stimulated glucose uptake in adipocytes and in vivo insulin sensitivity using the fasting insulin resistance index (FIRI) in 60 subjects (45 Caucasian and 15 Asian) with CHD and 30 Caucasian subjects without CHD. In 25 CHD subjects (18 Caucasian and 7 Asian), the relationship between adipocyte insulin sensitivity and non-esterified fatty acid (NEFA) suppression to oral glucose was examined. Compared with controls, the CHD subjects had higher values of fasting insulin [51 (46 to 54) pmol l⁻¹ vs 36 (31 to 41) pmol l⁻¹ p < 0.01] and FIRI [1.65 (1.5 to 1.79) vs 1.06 (0.89 to 1.23), p < 0.01]. Among the CHD subjects, the Asians had higher values than Caucasian [insulin 58 (48 to 67) pmol l⁻¹ vs 48 (44 to 53) pmol l⁻¹ p < 0.01, FIRI 1.89 (1.44 to 2.13) vs 1.62 (1.4 to 1.79), p < 0.01)]. Insulin-stimulated glucose uptake in adipocytes was lower in the CHD than control subjects [56 (50 to 62) vs 115 (75 to 132) attomol min⁻¹.mm², p < 0.05], being most reduced among the Asians. It was positively correlated with postprandial NEFA suppression and negatively with insulin release. In conclusion, abnormalities of adipocyte function and insulin sensitivity occur in CHD and may contribute to its aetiology. Copyright © 1998 John Wiley & Sons, Ltd.     

A prospective comparative study of ASCA and pANCA in Chinese and Caucasian IBD patients

BACKGROUND: Inflammatory bowel disease manifests throughout all ethnic groups. Antisaccharomyces cerevisiae (ASCA) and antineutrophil cytoplasmic antibodies (pANCA) can aid in the differentiation between Crohn's disease (CD) and ulcerative colitis (UC), but their sensitivity may vary between races. OBJECTIVES: This study compared the sensitivity, specificity, and positive and negative predictive values (PPV, NPV) of pANCA and ASCA between Chinese and Caucasian IBD populations and identified disease subtype associations. RESULTS: Three hundred patients were prospectively recruited from Caucasian and Chinese populations (CD, n = 50, UC, n = 50, controls, n = 50 each). pANCA detection was greater in Caucasian than Chinese UC patients (p= 0.046). ASCA IgG detection was similar, but IgA was lower in Chinese CD patients (p < 0.001). Differentiation between UC and CD (+ve pANCA/-ve ASCA) demonstrated a PPV of 92% in isolated colonic disease. Logistic regression in CD identified positive pANCA had a lower association with ileal (OR = 6.8, p= 0.0067) and complicated disease (OR = 5.5, p= 0.015). Caucasian CD patients with positive ASCA IgA/IgG had a greater association with ileal (OR = 6.7, p= 0.022) or complicated disease (OR = 9.4, p= 0.0073) and in Chinese CD patients positive ASCA IgA/IgG was associated with isolated ileal disease (OR = 16.8, p= 0.032). Linear regression demonstrated that higher ASCA titers predicted complicated CD and isolated ileal disease. CONCLUSIONS: This study identified that pANCA is more sensitive in Caucasian than Chinese UC and that ASCA IgA has a low yield in Chinese CD. pANCA and ASCA are useful for differentiating between UC and CD in both populations, and ASCA IgG and IgA titers have potential use in determining the risk of developing complicated CD.     

血清瘦素水平与胰岛素原、真胰岛素及胰岛素敏感性的关系

目的　研究中国人群空腹瘦素水平与真胰岛素 (TI)、胰岛素原 (PI)、PI/TI比值及胰岛素敏感性之间的关系。方法　 90 2例非糖尿病者均系 2 0 0 0年接受糖尿病流行病学调查者。测定空腹瘦素、TI和PI浓度以及空腹及餐后 2h血糖。瘦素、TI及PI检测采用本室建立的特异的酶联免疫分析法 (ELISA)。胰岛素敏感性以HOMA胰岛素抵抗指数 (HOMA IR)评价。结果　血清瘦素水平女性高于男性。相关分析显示血清瘦素水平与空腹TI、PI及HOMA IR显著正相关 (男性 792例 ,r分别为0 345、0 2 36和 0 364 ;女性 1 1 0例 ,r分别为 0 574、0 375和 0 576 ,P <0 0 0 1 ) ,但与空腹血糖仅在男性呈弱相关 (r=0 1 5 ,P =0 0 1 5) ,与空腹PI/TI比值不相关。在调整年龄、体重指数 (BMI)和腰臀围比(WHR)后 ,尽管相关性减弱 ,瘦素水平仍然与TI、PI以及HOMA IR显著相关。结论　本组的血清瘦素浓度与TI、PI以及胰岛素抵抗显著正相关 ,且在一定程度上独立于肥胖和脂肪分布。瘦素水平高或瘦素抵抗的个体可能存在高胰岛素血症和胰岛素抵抗 ,提示其瘦素 胰岛素轴的调节异常。本研究未发现瘦素水平与空腹PI/TI比值的相关 ,提示瘦素可能与这一反映胰岛 β细胞的功能异常的标志无关。本研究揭示的高瘦素 高胰岛素血症或胰岛素抵抗之间的     

Epicardial adipose tissue and insulin resistance in obese subjects

CONTEXT: Epicardial adipose tissue has been recently recognized as a source of bioactive molecules as well as free fatty acids, adiponectin, and inflammatory cytokines. Epicardial fat reflects intraabdominal visceral fat, and the echocardiographic assessment of this tissue is an easy and reliable marker of visceral adiposity. OBJECTIVE: In this study we evaluated whether epicardial adipose tissue is related to insulin sensitivity and glucose metabolism in obese subjects. PATIENTS: Thirty obese subjects (20 women and 10 men; mean age, 40.8 +/- 11.5 yr; body mass index, 43 +/- 9.1 kg/m2) were included in this study. No subject was taking drugs or had a history or evidence of metabolic, cardiovascular, respiratory, or hepatic disease. MAIN OUTCOME MEASURES: Each subject underwent a transthoracic echocardiogram to evaluate epicardial adipose tissue thickness, a euglycemic hyperinsulinemic clamp to estimate insulin sensitivity, and an oral glucose tolerance test to evaluate glucose tolerance. RESULTS: The thickness of the epicardial adipose tissue on the right ventricle varied between 4 and 17.4 mm. Echocardiographic epicardial adipose tissue was significantly correlated with whole-body glucose uptake index from the clamp and with all indices of insulin resistance and glucose intolerance measured, except the 120-min plasma glucose level after an oral glucose tolerance test. CONCLUSIONS: Our study showed that the epicardial fat is significantly related to obesity-related insulin resistance. This finding could be of potential interest in clinical practice and research of obesity-related risk stratification.     

Pathophysiology of insulin resistance in subjects born small for gestational age

Over the last 15 years, a number of long-term health risks associated with reduced fetal growth have been identified, including cardiovascular diseases, hypertension, dyslipidaemia and type 2 diabetes. A common feature of these conditions is insulin resistance, which is thought to play a pathogenic role. However, despite abundant data in the literature, it is still difficult to trace the pathway by which fetal events, environmental or not, may lead to increased morbidity later in life. To explain this association, several hypotheses have been proposed pointing to the role of a detrimental fetal environment, a genetic susceptibility or an interaction between the two, and of the particular dynamic changes in adiposity that occur during catch-up growth. The relative impact of early postnatal events in relation to fetal growth has to be considered for designing health policy strategies for early interventions aimed at decreasing disease risk throughout life.     

空腹血糖异常人群胰岛素分泌功能及胰岛素抵抗状态的探讨

目的　探讨空腹血糖异常人群的胰岛素分泌及胰岛素抵抗状态。　方法　选择包钢糖尿病普查中复查口服葡萄糖耐量试验 (OGTT) 3985例 ,分为 6组 :正常糖耐量 (NGT)组 2 5 88例 ,异常空腹血糖 (IFG)组 2 72例 ,糖耐量减低 (IGT)组 4 4 9例 ,空腹血糖异常伴糖耐量减低 (IFG/ IGT)组116例 ,新诊断糖尿病 (DM1)组 338例 ,已知糖尿病 (DM2 )组 2 2 2例。测腰围、体重指数、血压、血脂及血浆胰岛素 ,应用稳态模式胰岛素抵抗指数 (HOMA- IR)作为胰岛素抵抗指标 ,稳态模式胰岛 β细胞功能指数 (HBCI)及胰岛素分泌指数 (IS)作为胰岛素分泌指标 ,并对 6组患者的这些指标及临床特征 ,进行对比分析。　结果　与 NGT组比较 ,IFG组 HOMA- IR(1.4 6± 0 .6 0 ,1.0 6± 0 .6 4 ,t=- 6 .716 ,P<0 .0 0 1)、空腹胰岛素 (FINS) (17.90± 10 .0 6 ,15 .79± 10 .94 ,t=- 2 .0 71,P=0 .0 39)增高 ,HB-CI(4.6 5± 0 .6 0 ,5 .2 7± 0 .76 ,t=3.399,P<0 .0 0 1)及 IS(0 .86± 0 .6 0 ,0 .99± 0 .6 2 ,t=2 .36 6 ,p=0 .0 18)降低 ;IGT组 HOMA- IR(1.39± 0 .5 8,t=4 .6 98) ,FINS(2 1.2 7± 15 .39,t=4 .4 93)、2 - h胰岛素(6 0 .84± 37.86 ,t=8.4 82 )、HBCI(5 .4 7± 0 .79,t=2 .6 98)、IS(1.2 5± 0 .6 1,t=4 .0 34,P值均 <0     

Acromegaly and insulin resistance: a case study

Elevated levels of growth hormone (GH) alter both the glucose tolerance and the sensitivity of peripheral tissue to insulin. We have studied the relationship between impaired glucose metabolism and its variations with different plasma levels of endogenous GH in one patient with acromegaly. To do so, we studied the decline in blood glucose concentration, as induced by iv insulin infusion, from a given hyperglycaemic level. With high levels of GH (GH = 120 micrograms/l), the slope of the straight line representing the decrease in blood glucose after insulin infusion was -0.71, the time required to achieve normoglycaemic levels, 270 min, and the corrected area under the curve representing blood glucose 26 070 units2. After 10 months' bromocriptine treatment, GH plasma concentration fell to 8 micrograms/l, at which point the slope of the straight line was -1.40, the time required to achieve normoglycaemic levels 115 min, and the area under the curve 8956 units2. There was a greater total clearance of glucose when GH levels were lower (1.90 vs 1.00 ml/min/kg), as well as greater elimination of glucose from the extracellular glucose pool (4.02 vs 1.67 mg/min/kg). In conclusion, in this patient the elevated plasma levels of endogenous GH induced insulin resistance. Once GH levels were reduced by the administration of bromocriptine, glucose metabolism improved.     

Incidence of insulin resistance in obese subjects in a rural Japanese population: the Tanno and Sobetsu study

OBJECTIVES: Although it is well known that obesity is closely related to insulin resistance, the incidence of the development of insulin resistance in people with obesity is not known. In this study, we investigated the incidence of insulin resistance in citizens of two rural communities in Japan. SUBJECTS AND METHODS: The subjects were 102 men and 126 women over the age of 30 years selected from 1035 citizens who had undergone medical examinations in the towns of Tanno and Sobetsu, Hokkaido, in 1991 and 1998. Those who were on medication for hypertension, diabetes, hyperlipidaemia, coronary heart disease and cerebral vessel disease were excluded. The simple index to determine insulin resistance [i.e. homeostasis model assessment (HOMA-R) > or = 1.73] was used, and subjects who were determined to be positive for insulin resistance according to this index in 1991 were also excluded in order to determine the incidence of insulin resistance in subjects who had no abnormalities other than obesity. The systolic blood pressure (SBP), diastolic blood pressure, body mass index (BMI), triglyceride level, high-density lipoprotein level, blood sugar level, serum insulin value and HOMA-R were measured in all subjects in 1991 and in 1998. Moreover, the subjects were divided into two groups according to BMI, a normal group consisting of subjects with BMI < 25 and an obesity group consisting of subjects with BMI > or = 25. We also compared the incidences of insulin resistance in normal and obesity groups of subjects who were newly determined to be positive for insulin resistance on the basis of data obtained from medical examinations conducted in 1998. RESULTS: The incidence of insulin resistance was significantly higher in the obesity group than in the normal group (25.0 vs. 4.5%). The results of logistic regression analysis showed that obesity was closely related to insulin resistance and that the relative risk of development of insulin resistance adjusted for age, sex, SBP, FPG and HDL was 3.193 (95% CI 1.085-9.401). CONCLUSIONS: The incidence of insulin resistance was significantly higher in the obesity group than in the normal group in this study, suggesting that improvement in obesity is important for prevention of the occurrence of type 2 diabetes or atherosclerotic disease based on insulin resistance.     

Risk variables of insulin resistance syndrome in African-American and Caucasian young adults with microalbuminuria: the Bogalusa heart study

Microalbuminuria is a strong predictor of cardiovascular disease. Previous studies are inconsistent regarding the relationship between microalbuminuria and insulin resistance syndrome. Therefore, we examined this relationship in 1031 young adults (61% Caucasian, 39% African-American) aged 19 to 32 years. Individuals with either urinary albumin to creatinine ratio at or above the 90th percentile (age, race, and gender specific) or urinary albumin level at or above 30 mg/L were considered as having slightly elevated albumin excretion (microalbuminuria). The multiple risk variables of insulin resistant syndrome measured include body mass index, waist circumference, blood pressure (BP), triglycerides, high-density lipoprotein (HDL) cholesterol, glucose, insulin, insulin resistance index (calculated from a homeostasis model assessment equation), and uric acid. After controlling for age and gender, African-Americans with microalbuminuria by either measure had higher mean systolic (P < .001) and diastolic (P < .05) BP, prevalence of hypertension (P < .05), and, contrary to expectations, HDL cholesterol (P < .05) than those without this condition. On the other hand, Caucasians showed no such associations. In African-Americans, the above differences in BP levels persisted when hypertensive subjects were excluded. None of the other risk variables displayed any relation to microalbuminuria in both races. These results suggest that microalbuminuria is not necessarily an intrinsic component of the insulin resistance syndrome, at least in the young adult age. Furthermore, the observed association between hypertension and microalbuminuria among young African-Americans may reflect early evidence of renal dysfunction due to the burden of elevated BP in this group.     

糖调节受损个体胰岛β细胞功能和胰岛素抵抗观察

评价152例人选者[正常糖耐量、空腹血糖受损和(或)糖耐量受损]胰岛β细胞功能和胰岛素抵抗.结果 显示空腹血糖受损者主要表现胰岛素早期分泌功能缺陷和基础分泌不足,胰岛素抵抗严重;糖耐量受损者则胰岛素早期和晚期分泌功能显著下降伴轻度胰岛素抵抗.     

INS VNTR allelic variation and dynamic insulin secretion in healthy adult non-diabetic Caucasian subjects.

AIMS: To elucidate the relationship between the human insulin gene INS VNTR regulatory polymorphism and insulin secretion. The polymorphism arises from tandem repetition of 14-15 bp oligonucleotides. In Caucasians, repeat number varies from 26 to over 200, with two main and discrete allele size classes: class I (26-63 repeats) and class III (141-209 repeats). Class I allele homozygosity is associated with elevated risk of developing Type 1 diabetes, while the class III allele has been associated with increased risk of Type 2 diabetes, polycystic ovary syndrome (PCOS) and with larger size at birth, which may influence development of adult disease. METHODS: Thirty-one healthy adult subjects with normal glucose tolerance, underwent an intravenous glucose tolerance test with one minute sampling. Seventeen subjects were homozygous for class I alleles (14 excluding individuals carrying alleles associated with parent-of-origin effects and heterogeneity in allele transmission) and 14 homozygous for class III alleles. The groups were well matched. RESULTS: No significant differences in amount or rate of insulin secretion, or beta cell function were detected between the two groups. There was a difference in pattern of pulsatile insulin secretion with more 9-minute oscillations in class I homozygotes (P<0.026). The after-load glucose concentration was also higher in subjects with class I alleles (P<0.03). CONCLUSIONS: These results warrant further analysis of possible association between allelic variation of the INS VNTR and the pulsatility of insulin secretion.     

The glycaemic index of a range of gluten-free foods.

AIMS: The number of people with both diabetes and coeliac disease is increasing. This study examined the effect of gluten-free, as opposed to gluten-replete carbohydrate containing foods, on post-prandial blood glucose concentrations. METHODS: The glycaemic index of six commonly used gluten-free carbohydrates are reported and compared with published figures for similar non-gluten-free products. RESULTS: The results indicate that the glycaemic index of gluten-free and gluten containing foods are similar. CONCLUSIONS: The inclusion of gluten-free foods in the diet of diabetic individuals with coeliac disease should not compromise glycaemic control.     

Alcohol intake and insulin resistance. A cross-sectional study

BACKGROUND AND AIM: The development of insulin resistance is a critical step in the pathogenesis of type 2 diabetes. The effect of alcohol intake on insulin sensitivity/resistance is not well defined. The aim of this study was to examine the association between alcohol intake and insulin resistance in a sample of middle-aged men and women with data on a wide range of potential confounding factors, including diet. METHODS: We performed a cross sectional study involving a group of 1018 men and women, sampled from 17 general practice lists in the South of Ireland, with a response rate of 69%. Participants completed a detailed health and lifestyle questionnaire and a food frequency questionnaire and provided fasting blood samples for analysis of glucose and insulin. Insulin resistance was estimated on the basis of fasting glucose and insulin, using the glucose homeostasis model (HOMA scores). Insulin resistance was defined as the upper quartile of the HOMA scores. RESULTS: We found evidence of a U-shaped relationship between alcohol intake and insulin resistance fitted as a continuous variable (HOMA scores) with lowest levels in light drinkers (between 0.5 to 0.99 units per day) relative to the other drinking categories. However no significant association between alcohol intake and HOMA score was observed in fully adjusted analyses, including adjustment for dietary saturated fat and fruit and vegetables intake. In logistic regression analysis with insulin resistance (categorical) as the dependent variable, we observed that ex-drinkers were at higher risk of insulin resistance compared to occasional drinkers independently of age, sex, BMI and waist circumference, (OR=2.4, 95% CI, 1.1-5.7, p=0.04). On further adjustment for potential confounders including diet this association was also attenuated and was non-significant. CONCLUSIONS: The reported effects of alcohol intake on insulin resistance may be confounded by other aspects of lifestyle, especially diet.     

Comparison of insulin sensitivity tests across a range of glucose tolerance from normal to diabetes

Aims/hypothesis. Adequate comparison of the relative performance of insulin sensitivity tests is not yet available. We compared the discrimination of four insulin sensitivity tests, commonly used in vivo, across a range of glucose tolerance. Methods. Normal (n = 7), impaired glucose tolerant (n = 8) and Type II (non-insulin-dependent) diabetic subjects (n = 9) had in random order two tests from the following: frequently sampled insulin-modified intravenous glucose tolerance test (FSIVGTT-MinMod); homeostasis model assessment (HOMA) and 2-h continuous infusion of glucose with model assessment (CIGMA) with immunoreactive or specific insulin; short insulin tolerance tests (ITT). The discriminatory power of tests was assessed by the ratio of the within-subject standard deviation to the underlying between-subject standard deviation (discriminant ratio –DR). The degree to which tests measured the same variable was assessed by comparing rank correlation with the maximum expected correlation given the imprecision of the tests. The unbiased lines of equivalence taking into account the precision of tests were constructed. Results. Reciprocal fasting plasma insulin (FPI^–1), HOMA %S and 2-h CIGMA %S, had similar DRs with ITT being less informative. The FSIVGTT-MinMod analysis was able to assess 13 out of 24 subjects and had a performance similar to ITT. Using specific rather than immunoreactive insulin for HOMA-CIGMA did not improve the DR. Reciprocal fasting plasma insulin FPI^–1, HOMA %S, 2-h CIGMA %S and S_I FSIVGTT intercorrelated more than 90 % of the expected rank correlation given the imprecision of the tests, but ITT gave only limited correlation. Conclusion/interpretation. The HOMA-CIGMA test with immunoreactive insulin provides similar information in distinguishing insulin sensitivity between subjects with normal glucose tolerance, those with impaired glucose tolerance and those with Type II diabetes as does FSIVGTT, whereas ITT is less informative. [Diabetologia (1999) 42: 678–687] Received: 14 September 1998 and in revised form: 4 February 1999     

长期吸烟与胰岛素抵抗的关系

研究了NGT吸烟者69例，不吸烟者59例，以及IGT吸烟者96例和不吸烟者72例。结果显示：NGT不吸烟者与IGT吸烟者之间的体质指数无显著差异。NGT吸烟者和IGT吸烟者之间，胰岛素作用指数、胰岛素抵抗和胰岛素分泌指数均存在显著差异。结论是长期吸烟引起胰岛素抵抗，并使NGT和IGT人群无效胰岛素分泌。