Endogenous insulin secretion ability in meal tolerance test correlated with body mass index (BMI) in Japanese type 2 diabetes patients

详细信息    查看全文

• 作者：Tsuyoshi Ohkura ; Youhei Fujioka…
• 关键词：Meal tolerance test ; CPR ; Japanese ; Body mass index
• 刊名：International Journal of Diabetes in Developing Countries
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：34
• 期：4
• 页码：193-200
• 全文大小：271 KB
• 参考文献：1. DeFronzo RA. Lilly lecture 1987. The triumvirate: beta-cell, muscle, liver. A collusion responsible for NIDDM. Diabetes. 1988;37:667-7. CrossRef
  2. Kadowaki T, Miyake Y, Kajinuma H. Risk factors for worsening to diabetes in subjects with impaired glucose tolerance. Diabetologia. 1984;26:44-. CrossRef
  3. Kadowaki T, Yoshinaga H. Risk factors for the development of non-insulin-dependent diabetes mellitus (NIDDM) in Japan. Diabetes Res Clin Pract. 1994;24:123-. CrossRef
  4. Faber OK, Binder C. C-peptide response to glucagons, a test for the residual b-cell function in diabetes mellitus. Diabetes. 1977;26:605-0. CrossRef
  5. Greenbaum CJ, Mandrup-Poulsen T, McGee PF, Battelino T, Haastert B, Ludvigsson J, et al. Mixed-meal tolerance test versus glucagon stimulation test for the assessment of beta-cell function in therapeutic trials in type 1 diabetes. Diabetes Care. 2008;31:1966-1. CrossRef
  6. Funakoshi S, Fujimoto S, Hamasaki A, Fujiwara H, Fujita Y, Ikeda K, et al. Analysis of factors influencing pancreatic beta-cell function in Japanese patients with type 2 diabetes: association with body mass index and duration of diabetic exposure. Diabetes Res Clin Pract. 2008;82:353-. CrossRef
  7. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2007;30 Suppl 1:S42-. CrossRef
  8. The Committee of Japan Diabetes Society on the diagnostic criteria of diabetes mellitus. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. J Jpn Diabetes Soc 2010;53:450-7.
  9. Youden WJ. Index for rating diagnostic tests. Cancer. 1950;3:32-. CrossRef
  10. Perkins NJ, Schisterman EF. The inconsistency of “optimal-cutpoints obtained using two criteria based on the receiver operating characteristic curve. Am J Epidemiol. 2006;163:670-. CrossRef
  11. Butler AE, Janson J, Bonner-Weir S, Ritzel R, Rizza RA, Butler PC. b-cell deficit and increased b-cell apoptosis in humans with type 2 diabetes. Diabetes. 2003;52:102-0. CrossRef
  12. Yoon KH, Ko SH, Cho JH, Lee JM, Ahn YB, Song KH, et al. Selective beta-cell loss and alpha-cell expansion in patients with type 2 diabetes mellitus in Korea. J Clin Endocrinol Metab. 2003;88:2300-. CrossRef
  13. Kim DJ, Lee MS, Kim KW, Lee MK. Insulin secretory dysfunction and insulin resistance in the pathogenesis of Korean type 2 diabetes mellitus. Metabolism. 2001;50:590-. CrossRef
  14. Lu WG, Pipeleers DG, Kloppel G, Bouwens L. Comparative immunocytochemical study of MHC class II expression in human donor pancreas and isolated islets. Virchows Arch. 1996;429:205-1.
  15. Besser RE, Jones AG, McDonald TJ, Shields BM, Knight BA, Hattersley AT. The impact of insulin administration during the mixed meal tolerance test. Diabet Med. 2012;29:1279-4. CrossRef
  16. Meier JJ, Pennartz C, Schenker N, Menge BA, Schmidt WE, Heise T, et al. Hyperglycaemia is associated with impaired pulsatile insulin secretion: effect of basal insulin therapy. Diabetes Obes Metab. 2013;15:258-3. CrossRef
  17. Hovorka R, Albarrak A, Chassin L, Luzio SD, Playle R, Owens DR. Relationship between beta-cell responsiveness and fasting plasma glucose in Caucasian subjects with newly presenting type 2 dia
• 刊物主题：Medicine/Public Health, general; General Practice / Family Medicine; Health Administration; Diabetes;
• 出版者：Springer India
• ISSN：1998-3832

文摘

Several studies report that endogenous insulin secretion (EIS) ability is correlated with BMI in glucagon stimulation tests (GST). Despite a standard method to assess EIS, GST can produce side effects such as nausea. Therefore, we investigated the relationship between EIS and BMI with a simple meal tolerance test (MTT). One-hundred type 2 diabetes mellitus (T2DM) patients (average: age 61, HbA1c 9.2?%, BMI 25.0?kg/m2, duration of DM 11.5?years) subjected to a MTT. We measured serum C-peptide immunoreactivity (CPR) at fasting, and 2?h after a calorie controlled breakfast, and calculated the difference to give ΔCPR. The fasting and postprandial CPR significantly correlated with BMI (R--.59, R--.48, P--.0001, respectively). ΔCPR also significantly correlated to BMI (R--.34, P--.001). HbA1c had a significant negative association of ΔCPR (R-??0.38, P--.0005). The optimal cut-off level of BMI to predict ΔCPR 2 using the ROC curve (sensitivity 83?%, specificity 88?%). Using multiple regression analysis, we examined influence factors of ΔCPR; the significant standard partial regression coefficients were: BMI 0.254, insulin use ?.237, HbA1c -0.358 (P--.05). The HbA1c level in BMI > 25.0?kg/m2 was significantly higher in patients with 1.0 = 2.0 (10.0?% vs. 8.5?%). The BMI significantly correlated with EIS ability in a MTT, and is a simple index to predict EIS. The insulin secretion ability diminished in patients with BMI 2, and BMI > 25?kg/m2 but high HbA1c > 10?%.