Hepatic insulin clearance is increased in patients with high HbA1c type 2 diabetes: a preliminary report

高 HbA1c 2 型糖尿病患者的肝脏胰岛素清除率增加:初步报告

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作者:Tsuyoshi Okura, Yohei Fujioka, Risa Nakamura, Mari Anno, Yuichi Ito, Sonoko Kitao, Kazuhisa Matsumoto, Kyoko Shoji, Keisuke Sumi, Kazuhiko Matsuzawa, Shoichiro Izawa, Hiroko Okura, Etsuko Ueta, Hisashi Noma, Masahiko Kato, Takeshi Imamura, Shin-Ichi Taniguchi, Kazuhiro Yamamoto

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.

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.

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