题名：The metabolic responses induced by acute dexamethasone predict glucose tolerance and insulin secretion over 10 years in relatives of type 2 diabetic subjects.
作者：DURCK TT; HENRIKSEN JE; EGEDE MB; LEVIN K; RANTZAU C; WARD G; BECK-NIELSEN H; ALFORD FP;
来源：Diabetes Metab Res Rev. 2013 Sep;29(6):492-8. doi: 10.1002/dmrr.2418. [ IF= 0.00 ] ]
摘要：BACKGROUND: This study aimed to compare the metabolic and insulin secretory
responses to dexamethasone with the metabolic responses observed at 10 years in
normoglycaemic relatives of type 2 diabetic and healthy control subjects.
METHODS: Twenty relatives and 20 matched control subjects were studied twice at 0
year (pre- and post-dexamethasone) and at 10 years, employing a 75-g oral glucose
tolerance test (OGTT), with serial measurements of glucose and insulin, for
determination of glucose tolerance and calculations of acute insulin release
(DeltaI30 /DeltaG30 ; insulinogenic index) and insulin sensitivity (SIHOMA ).
RESULTS: Following dexamethasone, the relatives group developed varying degrees
of glucose intolerance, associated with reduced insulin sensitivity and
insulinogenic index. By 10 years, fasting glucose and 2-h OGTT glucose were
raised in the relatives group, especially in the relatives most metabolically
affected by dexamethasone, including a reduced insulinogenic index. Multiple
regression analysis of the data in relatives demonstrated that the 2-h OGTT
glucose and fasting glucose values at 10 years depended on the 0-year
post-dexamethasone 2-h OGTT glucose, post-dexamethasone fasting glucose and
post-dexamethasone insulin sensitivity, r(2) adj = 56% (p < 0.001) and r(2) adj =
60% (p < 0.0001), respectively. No pre-dexamethasone metabolic or insulin
secretory responses entered these models. CONCLUSIONS: In relatives, fasting and
2-h OGTT glucose concentrations and beta-cell responses to acute
dexamethasone-induced insulin resistance are similar to those observed at 10
years, especially in relatives who develop the most disturbed
dexamethasone-induced glucose intolerance and impaired acute insulin secretion.
The combined 0-year, post-dexamethasone fasting and 2-h OGTT glucose
concentrations and insulin resistance, measured as SIHOMA , are the best
predictors in relatives of future dysglycaemia. Copyright (c) 2013 John Wiley &