在糖尿病前期的炎症与胰岛素抵抗增加有关,而不是胰岛素分泌量下降
Andreas Festa1, Anthony J G Hanley, Russell P Tracy
1Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Tex 78229-3900, USA.
Circulation
|October 1, 2003
概括
患有胰岛素抵抗的糖尿病前患者表现出较高的炎症蛋白水平,表明心血管疾病风险增加. 那些患有主要β细胞缺陷的人不会表现出这种增强的炎症状态.
科学领域:
- 内分泌学 在内分泌学.
- 心血管医学 心血管医学
- 代谢综合征是代谢综合征的一种.
背景情况:
- 增高的促炎蛋白质预测心血管疾病和2型糖尿病.
- 糖尿病前期的异位变化以前与胰岛素耐药性有关,而不是胰岛素分泌受损.
研究的目的:
- 为了研究炎症标志物与糖尿病前患者胰岛素敏感性和分泌的缺陷之间的关系.
- 为了确定胰岛素耐药性或糖尿病前期胰岛素分泌受损是否与炎症状态有关.
主要方法:
- 从胰岛素抵抗性动脉样硬化研究 (IRAS) 中分析了糖尿病前患者的C反应蛋白 (CRP),等离子体激活剂抑制剂 (PAI) -1和纤维素原水平.
- 评估胰岛素敏感性 (SI) 和第一阶段胰岛素分泌,使用频繁采样的静脉输入葡萄糖耐受性测试.
- 在胰岛素耐药和胰岛素敏感的糖尿病前患者,以及患上或没有患上糖尿病的患者之间,对炎症标志物的比较.
主要成果:
- 与胰岛素敏感个体相比,抗胰岛素的糖尿病前患者的PAI-1和CRP水平显著更高.
- 患有主要胰岛素耐药性的糖尿病前患者表现出比胰岛素分泌量下降或非转化剂患者更高的炎症蛋白水平.
- 在胰岛素分泌初级缺陷的糖尿病前患者和非转化剂者之间没有观察到炎症蛋白质水平的显著差异.
结论:
- 糖尿病前期患有主导胰岛素耐药性的人群中明显增加了预炎症状态,但患有主要β细胞功能障碍的人群中并非如此.
- 这些发现表明,具有高胰岛素耐药性的糖尿病前期患者患心脏病的风险增加.
- 这项研究突出了导致糖尿病前期心血管风险的独特病理生理路径.
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