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

Lipids in Health and Disease

Research

Shang-Yu Chai¹  Fei Li¹  Yue-Ye Huang¹  Ke-Xiu Song¹  Xiao-Yun Cheng¹  Xiao-Yu Pan¹  Shen Qu² 

[1] Department of Endocrinology, Shanghai 10th People’s Hospital, Tongji University, Shanghai, China;Department of Endocrinology, Shanghai 10th People’s Hospital, Tongji University, Shanghai, China;Shanghai 10th People’s Hospital, Nanjing Medical University, 301 Middle Yanchang Road, Shanghai, China;

关键词: Nonalcoholic fatty liver disease;    Impaired glucose tolerance;    Type 2 diabetes mellitus;    Hyperinsulinemia;    Insulin resistance;   

DOI  :  10.1186/1476-511X-13-7

 received in 2013-11-22, accepted in 2014-01-03,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundNonalcoholic 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.MethodsPatients 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.ResultsPatients with DM-NAFLD or T2DM alone had similar blood glucose levels. β-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 (ΔC-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.ConclusionsIn 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 β-cell hypersecretion. The present study demonstrates pathophysiological differences in mechanisms of insulin resistance in patients with DM-NAFLD versus T2DM alone.

【 授权许可】

Unknown   
© Chai et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.