详细记录  
题名:Differential patterns of insulin secretion and sensitivity in patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease versus patients with type 2 diabetes mellitus alone.
作者:CHAI SY; PAN XY; SONG KX; HUANG YY; LI F; CHENG XY; QU S;
来源:Lipids Health Dis. 2014 Jan 7;13(1):7. doi: 10.1186/1476-511X-13-7. [ IF= 0.00 ] ]
URL :10.1186/1476-511X-13-7
日期:20140217
摘要:BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus
(T2DM) often coexist and have adverse outcomes. The aim of our study was to
elucidate metabolic abnormalities in patients with DM-NAFLD versus those with
T2DM alone. METHODS: Patients were divided into two groups: 26 T2DM patients with
NAFLD and 26 gender-, age-, and body mass index-matched patients with T2DM alone.
Patients took a 75-g oral glucose tolerance test (OGTT), which measured serum
insulin and C-peptide (C-p) levels at baseline (0 min), 30 min, 60 min, and 120
min after glucose challenge. RESULTS: Patients with DM-NAFLD or T2DM alone had
similar blood glucose levels. beta-cell hypersecretion was more obvious in
patients with DM-NAFLD. In addition, fasting, early-phase, and late-phase
C-peptide levels were significantly increased in patients with DM-NAFLD (DeltaC-p
0-30 min, P < 0.05; Area Under the Curve (AUC) C-p/PG 30-120 min ratio, P < 0.01;
and AUC C-p 30-120 min, P < 0.01). Hepatic and extrahepatic insulin resistance
during the OGTT did not differ significantly between groups. Hepatic insulin
sensitivity independently contributed to the early phase (0-30 min) of the OGTT
in patients with T2DM and NAFLD, whereas a significant deficit in late insulin
secretion independently contributed to the 30-120 min glucose status in patients
with T2DM only. CONCLUSIONS: In patients with similar levels of insulin
resistance and hyperglycemia, DM-NAFLD was associated with higher serum insulin
levels than T2DM alone. Hyperinsulinemia is caused mainly by beta-cell
hypersecretion. The present study demonstrates pathophysiological differences in
mechanisms of insulin resistance in patients with DM-NAFLD versus T2DM alone.

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