フルテキストファイル
著者
Okura, Tsuyoshi Division of Endocrinology and Metabolism, Tottori University 研究者総覧 KAKEN
Fujioka, Yohei Division of Endocrinology and Metabolism, Tottori University 研究者総覧 KAKEN
Nakamura, Risa Division of Endocrinology and Metabolism, Tottori University
Anno, Mari Division of Endocrinology and Metabolism, Tottori University
Ito, Yuichi Division of Endocrinology and Metabolism, Tottori University
Kitao, Sonoko Division of Endocrinology and Metabolism, Tottori University
Matsumoto, Kazuhisa Division of Endocrinology and Metabolism, Tottori University
Shoji, Kyoko Division of Endocrinology and Metabolism, Tottori University
Sumi, Keisuke Division of Endocrinology and Metabolism, Tottori University
Matsuzawa, Kazuhiko Division of Endocrinology and Metabolism, Tottori University 研究者総覧
Izawa, Shoichiro Division of Endocrinology and Metabolism, Tottori University 研究者総覧 KAKEN
Okura, Hiroko Division of Endocrinology and Metabolism, Tottori University
Ueta, Etsuko School of Health Science, Tottori University
Noma, Hisashi Institute of Statistical Mathematics
Kato, Masahiko School of Health Science Major in Clinical LaboratoryScience, Tottori University 研究者総覧 KAKEN
Imamura, Takeshi Division of Molecular Pharmacology, Tottori University 研究者総覧 KAKEN
Taniguchi, Shin-ichi Department of Regional Medicine, Tottori University 研究者総覧 KAKEN
Yamamoto, Kazuhiro Division of Endocrinology and Metabolism, Tottori University 研究者総覧 KAKEN
キーワード
insulin
clearance and action
type 2 diabetes
insulin clamp
抄録
Introduction: Hepatic insulin clearance (HIC) is an important pathophysiology of type 2 diabetes. HIC was reported to decrease in patients with type 2 diabetes and metabolic syndrome. However, hyperglycemia was suggested to enhance HIC, and it is not known whether poorly controlled diabetes increases HIC in patients with type 2 diabetes. We investigated whether HIC was increased in patients with poorly controlled diabetes, and whether HIC was associated with insulin resistance and incretins. Research: design and methods We performed a meal tolerance test and the hyperinsulinemic–euglycemic clamp in 21 patients with type 2 diabetes. We calculated the postprandial C-peptide area under the curve (AUC)-to-insulin AUC ratio as the HIC; measured fasting and postprandial glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and glucagon levels and analyzed serum adiponectin and zinc transporter-8 (ZnT8) gene polymorphism. Results: The HIC significantly correlated with glycated hemoglobin (HbA1c) (r_S=0.58, p<0.01). In patients with high HIC above the median of 6.5, the mean HbA1c was significantly higher compared with low HIC below the median. Homeostatic model assessment (HOMA)-beta (r_S=−0.77, p<0.01) and HOMA-IR (r_S=−0.66, p<0.005) were correlated with HIC. The M/I value in the clamp study was correlated with HIC. GLP-1-AUC and GIP-AUC were not correlated with HIC. Glucagon-AUC was negatively correlated with HIC, but there were no significant differences between the high and low HIC groups. Adiponectin was positively correlated with HIC. The ZnT8 gene polymorphism did not affect HIC. Conclusions: These results suggest that HIC was increased in patients with high HbA1c type 2 diabetes, low insulin secretion, low insulin resistance and high adiponectin conditions.
出版者
BMJ
資料タイプ
学術雑誌論文
外部リンク
EISSN
20524897
掲載誌名
BMJ OPEN DIABETES RESEARCH & CARE
最新掲載誌名
BMJ OPEN DIABETES RESEARCH & CARE
8
1
発行日
2020-01
出版者DOI
著者版フラグ
出版社版
著作権表記
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
掲載情報
Okura Tsuyoshi, Fujioka Yohei, Nakamura Risa, et al. Hepatic insulin clearance is increased in patients with high HbA1c type 2 diabetes: a preliminary report. BMJ OPEN DIABETES RESEARCH & CARE. 2020. 8(1). doi:10.1136/bmjdrc-2019-001149
部局名
医学部・医学系研究科・医学部附属病院
言語
英語
Web of Science Key ut
WOS:000534740200060