Impact of one-hour postchallenge glucose on the relationship between insulin sensitivity and secretion.
Endocr J
; 62(7): 573-83, 2015.
Article
em En
| MEDLINE
| ID: mdl-26052138
ABSTRACT
The impact of postchallenge glucose on the relationship between insulin sensitivity (SI) and secretion (ß) is unknown. We analyzed data from 2,264 health examinees (male/female 1,524/740, median age 54 yrs) with normal glucose tolerance (NGT, n = 1,623), non-diabetic hyperglycemia (NDH, n = 555), or diabetes (DM, n = 86) using OGTT-derived indices of SI (insulin sensitivity index [ISI]-Matsuda, 1/HOMA-IR, and 1/fasting IRI) and ß (δIRI0-30/δPG0-30, and Stumvoll 1st [Stumvoll-1] and 2nd [Stumvoll-2] phases). The combination of 1/HOMA-IR and Stumvoll-1 recapitulated the hyperbolic SI-ß relationship with the slope of the fitted line -1.000 in NGT subjects, and therefore it was utilized in the following analysis of the SI-ß correlation. In multiple regression analysis of the relationship between SI and ß, an independent correlation was found for 1 h-plasma glucose (PG; PG60) but not for 2 h-PG. When the NGT subjects were grouped by PG60 quartile (Q), the fitted line was flat in Q1 but progressively steeper from Q2 to Q4, with a slope (95%CI) of -0.663 (-0.726~-0.605), -0.680 (-0.745~-0.622), -0.847 (-0.922~-0.779), and -1.259 (-1.370~-1.158) (P for trend < 0.05). The fitted line steepened further in the NDH and DM groups, with a slope of -1.545 and -1.915, respectively (P < 0.01 for the difference). The intercept of the fitted line for SI-ß correlation was also progressively lower across the PG60 Q for NGT, NDH, and DM. In conclusion, using the 1/HOMA-IR-Stumvoll-1 pair for an analysis of the SI-ß relationship, elevated PG60 was associated with steepening and downward shifting of the fitted line for the SI-ß correlation. The finding suggests impaired beta cell function.
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Base de dados:
MEDLINE
Assunto principal:
Resistência à Insulina
/
Intolerância à Glucose
/
Diabetes Mellitus
/
Glucose
/
Insulina
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article