Information de reference pour ce titreAccession Number: | 00003439-199509000-00018.
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Author: | Ludvik, Bernhard; Nolan, John J.; Baloga, Joseph; Sacks, David; Olefsky, Jerrold
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Institution: | From the Department of Medicine, Division of Endocrinology and Metabolism, University of California, San Diego, and Veterans Administration Hospital, San Diego, California. Address correspondence and reprint requests to Dr. Jerrold M. Olefsky, University of California, San Diego, and Veterans Administration Hospital, 3350 La Jolla Village Dr., San Diego, CA 92161. Received for publication 23 January 1995 and accepted in revised form 18 May 1995.
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Title: | Effect of Obesity on Insulin Resistance in Normal Subjects and Patients With NIDDM.[Article]
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Source: | Diabetes. 44(9):1121-1125, September 1995.
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Abstract: | Insulin resistance (IR) is a characteristic feature of non-insulin-dependent diabetes mellitus (NIDDM) as well as obesity, and a majority of NIDDM patients are obese. To assess the effect of obesity independent of NIDDM on IR, we studied the relationship between IR and obesity in 65 normal and 58 NIDDM subjects; we used body mass index (BMI) as a measure of obesity and glucose infusion rate (GINF) during a euglycemic hyperinsulinemic (120 mU [bullet] m sup -2 [bullet] min sup -1) glucose clamp as a measure of IR. In lean normal subjects, GINF was 57.7 plus/minus 2.2 micromole [bullet] kg sup -1 [bullet] min sup -1 (10.4 plus/minus 0.4 mg [bullet] kg sup -1 [bullet] min sup -1) and the lean NIDDM subjects were markedly insulin-resistant, with a GINF of 34.4 plus/minus 2.8 micromole [bullet] kg sup -1 [bullet] min sup -1 (6.2 plus/minus 0.5 mg [bullet] kg sup -1 [bullet] min sup -1). Obese normal subjects were also insulin-resistant compared with lean normal subjects, with a GINF of 36.1 plus/minus 2.2 micromole [bullet] kg sup -1 [bullet] min sup -1 (6.5 plus/minus 0.4 mg [bullet] kg sup -1 [bullet] min sup -1), and obesity caused an increase in IR in NIDDM, with a GINF of 21.1 plus/minus 1.4 micromole [bullet] kg sup -1 [bullet] min sup -1 (3.8 plus/minus 0.25 mg [bullet] kg sup -1 [bullet] min sup -1) in the obese NIDDM subjects. Therefore, approximately 61 percent of the IR in obese NIDDM subjects is due to NIDDM, with 39 percent due to obesity, demonstrating a greater impact of NIDDM than of obesity in causing IR. The correlation between GINF and BMI was much better in normal subjects (r = -0.75) than in NIDDM subjects (r = -0.50) as was the relationship between fasting insulin level and BMI (r = -0.59 in normal subjects, r = -0.48 in NIDDM subjects). As expected, the fasting insulin level was also strongly correlated to GINF in normal subjects (r = -0.61); however, this relationship was weaker in NIDDM subjects (r = -0.46). In conclusion, 1) obesity has a major impact to cause insulin resistance in nondiabetic subjects, but the effect of obesity on IR in NIDDM is less; 2) NIDDM per se is the major contributor to IR in NIDDM; and 3) the fasting insulin level is a better surrogate marker of IR in nondiabetic subjects than in NIDDM patients. Diabetes 44:1121-1125, 1995
(C) 1995 by the American Diabetes Association, Inc.
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Language: | English.
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Document Type: | Original Article.
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Journal Subset: | Clinical Medicine.
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ISSN: | 0012-1797
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NLM Journal Code: | e8x, 0372763
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Annotation(s) | |
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