糖尿病的研究新进展.pptVIP

* * Relationship between insulin sensitivity and -cell function quantified as the first-phase insulin response (AIRglucose) in 93 (55 men, 38 women) apparently healthy, nondiabetic subjects 45 y old. The cohort demonstrated a broad range of insulin sensitivity and -cell function; some lean individuals were as insulin resistant as obese subjects, whereas no obese subjects were insulin sensitive. The solid line depicts the best-fit relationship (50th percentile), whereas the broken lines represent the 5th, 25th, 75th and 95th percentiles. The relationship is best described by a hyperbolic function so that any change in insulin sensitivity is balanced by a reciprocal and proportionate change in -cell function. Reproduced from (6) . * * Percentile lines for the relationship between insulin sensitivity (SI) and the first-phase insulin response (AIRglucose) based on data from 93 normal subjects (6) . Mean data from six other studies are plotted. The ten subjects with type 2 diabetes were insulin resistant and had markedly impaired insulin secretion (47) . Thirteen healthy older subjects demonstrated that aging is associated with insulin resistance and a reduction in -cell function (23) . Reduced -cell function was also manifest in 8 women with a history of gestational diabetes (GDM) (7) , 11 women with polycystic ovarian disease (PCO) and a family history of type 2 diabetes (10) , 21 subjects with impaired glucose tolerance (IGT) (14) , and in 14 subjects with a first-degree relative with type 2 diabetes mellitus (48) . The reduction in -cell function in these last-mentioned three groups is compatible with their high risk of subsequently developing type 2 diabetes. * * Fig 1 Declining ? cell function combines with increasing insulin resistance to produce non-insulin dependent diabetes. When insulin resistance is severe only a small fall in ? cell function is required to produce diabetes (thick lines). Conversely, in insulin sensitive subjects (such as na