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Insulin resistance, endocrine function and adipokines in type 2 diabetes patients at different glycaemic levels: potential impact for glucotoxicity in vivo.
Clin Endocrinol (Oxf). 2006 Sep; 65(3):301-9.CE

Abstract

OBJECTIVE

To evaluate the interplay between hyperglycaemia, insulin resistance, hormones and adipokines in patients with type 2 diabetes mellitus (T2DM).

DESIGN AND METHODS

Ten patients with T2DM with good glycaemic control (G), 10 with poor control (P) and 10 nondiabetic control subjects (C) were matched for sex (M/F 6/4), age and body mass index. A hyperinsulinaemic, euglycaemic clamp was performed and cytokines and endocrine functions, including cortisol axis activity were assessed.

RESULTS

Patients with diabetes were more insulin resistant than group C, and group P exhibited the highest degree of insulin resistance (P = 0.01, P vs C). Tumour necrosis factor (TNF)-alpha levels were elevated in patients with diabetes (P = 0.05) and group P had the highest levels of fasting serum cortisol (P = 0.05), nonesterified fatty acids (NEFA; P = 0.06) and C-reactive protein (CRP; P = 0.01). Adiponectin levels were lower in the P group. In partial correlation analyses, significant associations were found: glycaemic level (HbA1c) with insulin resistance, TNF-alpha, CRP and basal and ACTH-stimulated cortisol levels, insulin resistance with plasma NEFA, TNF-alpha and stimulated cortisol levels.

CONCLUSION

Poor glycaemic control in patients with T2DM was associated with insulin resistance and with elevated TNF-alpha, CRP and basal as well as stimulated cortisol levels. Inflammatory mediators, e.g. TNF-alpha, may contribute to insulin resistance in hyperglycaemic patients with T2DM and this might be a partial explanation for glucotoxicity.

Authors+Show Affiliations

Department of Medicine, Umeå University Hospital, Umeå, Sweden.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16918948

Citation

Lindmark, S, et al. "Insulin Resistance, Endocrine Function and Adipokines in Type 2 Diabetes Patients at Different Glycaemic Levels: Potential Impact for Glucotoxicity in Vivo." Clinical Endocrinology, vol. 65, no. 3, 2006, pp. 301-9.
Lindmark S, Burén J, Eriksson JW. Insulin resistance, endocrine function and adipokines in type 2 diabetes patients at different glycaemic levels: potential impact for glucotoxicity in vivo. Clin Endocrinol (Oxf). 2006;65(3):301-9.
Lindmark, S., Burén, J., & Eriksson, J. W. (2006). Insulin resistance, endocrine function and adipokines in type 2 diabetes patients at different glycaemic levels: potential impact for glucotoxicity in vivo. Clinical Endocrinology, 65(3), 301-9.
Lindmark S, Burén J, Eriksson JW. Insulin Resistance, Endocrine Function and Adipokines in Type 2 Diabetes Patients at Different Glycaemic Levels: Potential Impact for Glucotoxicity in Vivo. Clin Endocrinol (Oxf). 2006;65(3):301-9. PubMed PMID: 16918948.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin resistance, endocrine function and adipokines in type 2 diabetes patients at different glycaemic levels: potential impact for glucotoxicity in vivo. AU - Lindmark,S, AU - Burén,J, AU - Eriksson,J W, PY - 2006/8/22/pubmed PY - 2007/1/16/medline PY - 2006/8/22/entrez SP - 301 EP - 9 JF - Clinical endocrinology JO - Clin Endocrinol (Oxf) VL - 65 IS - 3 N2 - OBJECTIVE: To evaluate the interplay between hyperglycaemia, insulin resistance, hormones and adipokines in patients with type 2 diabetes mellitus (T2DM). DESIGN AND METHODS: Ten patients with T2DM with good glycaemic control (G), 10 with poor control (P) and 10 nondiabetic control subjects (C) were matched for sex (M/F 6/4), age and body mass index. A hyperinsulinaemic, euglycaemic clamp was performed and cytokines and endocrine functions, including cortisol axis activity were assessed. RESULTS: Patients with diabetes were more insulin resistant than group C, and group P exhibited the highest degree of insulin resistance (P = 0.01, P vs C). Tumour necrosis factor (TNF)-alpha levels were elevated in patients with diabetes (P = 0.05) and group P had the highest levels of fasting serum cortisol (P = 0.05), nonesterified fatty acids (NEFA; P = 0.06) and C-reactive protein (CRP; P = 0.01). Adiponectin levels were lower in the P group. In partial correlation analyses, significant associations were found: glycaemic level (HbA1c) with insulin resistance, TNF-alpha, CRP and basal and ACTH-stimulated cortisol levels, insulin resistance with plasma NEFA, TNF-alpha and stimulated cortisol levels. CONCLUSION: Poor glycaemic control in patients with T2DM was associated with insulin resistance and with elevated TNF-alpha, CRP and basal as well as stimulated cortisol levels. Inflammatory mediators, e.g. TNF-alpha, may contribute to insulin resistance in hyperglycaemic patients with T2DM and this might be a partial explanation for glucotoxicity. SN - 0300-0664 UR - https://www.unboundmedicine.com/medline/citation/16918948/Insulin_resistance_endocrine_function_and_adipokines_in_type_2_diabetes_patients_at_different_glycaemic_levels:_potential_impact_for_glucotoxicity_in_vivo_ L2 - https://doi.org/10.1111/j.1365-2265.2006.02593.x DB - PRIME DP - Unbound Medicine ER -