糖尿病的研究新进展.ppt

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2025-02-23 发布于广东
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糖尿病的研究新进展.ppt

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**Relationshipbetweeninsulinsensitivityand-cellfunctionquantifiedasthefirst-phaseinsulinresponse(AIRglucose)in93(55men,38women)apparentlyhealthy,nondiabeticsubjects45yold.Thecohortdemonstratedabroadrangeofinsulinsensitivityand-cellfunction;someleanindividualswereasinsulinresistantasobesesubjects,whereasnoobesesubjectswereinsulinsensitive.Thesolidlinedepictsthebest-fitrelationship(50thpercentile),whereasthebrokenlinesrepresentthe5th,25th,75thand95thpercentiles.Therelationshipisbestdescribedbyahyperbolicfunctionsothatanychangeininsulinsensitivityisbalancedbyareciprocalandproportionatechangein-cellfunction.Reproducedfrom(6).**Percentilelinesfortherelationshipbetweeninsulinsensitivity(SI)andthefirst-phaseinsulinresponse(AIRglucose)basedondatafrom93normalsubjects(6).Meandatafromsixotherstudiesareplotted.Thetensubjectswithtype2diabeteswereinsulinresistantandhadmarkedlyimpairedinsulinsecretion(47).Thirteenhealthyoldersubjectsdemonstratedthatagingisassociatedwithinsulinresistanceandareductionin-cellfunction(23).Reduced-cellfunctionwasalsomanifestin8womenwithahistoryofgestationaldiabetes(GDM)(7),11womenwithpolycysticovariandisease(PCO)andafamilyhistoryoftype2diabetes(10),21subjectswithimpairedglucosetolerance(IGT)(14),andin14subjectswithafirst-degreerelativewithtype2diabetesmellitus(48).Thereductionin-cellfunctionintheselast-mentionedthreegroupsiscompatiblewiththeirhighriskofsubsequentlydevelopingtype2diabetes.**Fig1Declining?cellfunctioncombineswithincreasinginsulinresistancetoproducenon-insulindependentdiabetes.Wheninsulinresistanceissevereonlyasmallfallin?cellfunctionisrequiredtoproducediabetes(thicklines).Conversely,ininsulinsensitivesubjects(suchasna