Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2006, Vol. 28 ›› Issue (6): 740-744.

• Original Articles • Previous Articles     Next Articles

Application of Extended Hyperinsulinemic Euglycemic Clamp in the Assessment of Insulin Sensitivity in Obese Individuals with Glucose Intolerance

BAO Yu-qian, JIA Wei-ping, CHEN Lei, LU Jun-xi, ZHU Min, LU Wei, XIANG Kun-san   

  1. Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated SixthPeople’s Hospital, Shanghai 200233, China
  • Received:2006-07-10 Revised:1900-01-01 Online:2006-12-30 Published:2006-12-30
  • Contact: JIA Wei-ping

Abstract: ABSTRACT:Objective To study the changes of insulin sensitivity in individuals with impaired glucose tolerance and diabetes and the relationship between insulin sensitivity and over weight/obesity (OW/OB). Methods Fifty-two individuals were divided into 4 groups according to WHO diagnostic criteria of obesity (1998) and diabetes(1999):normal weight with normal glucose tolerance
(NW-NGT)group, OW/OB with normal glucose tolerance(OW/OB-NGT)group, OW/OB with impaired glucose tolerance(OW/OB-IGT)group and OW/OB with diabetes mellitus (OW/OB-DM)group. Individuals in OW/OB-NGT group were further classified into 3 subgroups:over weight subgroup, mild obesity subgroup, and mediate obesity subgroup. Abdominal fat area was measured with magnetic resonance imaging. Visceral obesity was defined as intra-abdominal fat area over 100 cm2. All subjects with NGT were divided into visceral obesity (VA) group and non-visceral obesity (Non-VA) group. Extended hyperinsulinemic euglycemic clamp was performed to assess the peripheral tissue insulin sensitivity in all subjects. Results The rates of insulin mediated glucose disappearance (Rd) were(3.25±0.13)mg·kg-1·min-1 in OW/OB-NGT group, (3.06±0.26)mg·kg-1·min-1 in OW/OB-IGT group, and(3.19±0.44)mg·kg-1·min-1 in OW/OB-DM group, which were significantly lower than that in NW-NGT group[(5.86±0.65)mg·kg-1·min-1](P<0.05,P<0.01). The Rd in over weight subgroup[(3.50±0.19)mg·kg-1·min-1], mild obesity subgroup[(3.03±0.13)mg·kg-1·min-1], and mediate obesity subgroup [(2.75±0.24)mg·kg-1·min-1]were significantly lower than that of NW-NGT group (P<0.05, P<0.01). The Rd[(2.97±0.12)mg·kg-1·min-1 vs(4.55±0.43)mg·kg-1·min-1]and glucose oxidation[(1.47±0.19)mg·kg-1·min-1 vs(2.24±0.19)mg·kg-1·min-1]in VA group were significantly decreased than that in non-VA group (P<0.05, P<0.01). Body mass index, waist and hip ratio, waist circumference, and intra-abdominal fat area were negatively correlated with Rd, respectively(P<0.01). Multiple regression analysis showed that body mass index, intra-abdominal fat area and abdominal subcutaneous fat area were the main risk factors of insulin sensitivity. Conclusions Insulin sensitivity decreased in OW/OB individuals with or without hyperglycemia. Insulin sensitivity is lower in subjects with visceral obesity. Total body fat and abdominal fat are the main risk factors of insulin sensitivity.

Key words: extended dyperinsulinemic euclycemic clamp, rate of clucose disappearance, obesity, diabetes