Serum α-hydroxybutyrate (α-HB) predicts elevated 1â
h glucose levels and early-phase ß-cell dysfunction during OGTT.
BMJ Open Diabetes Res Care
; 2(1): e000038, 2014.
Article
en En
| MEDLINE
| ID: mdl-25452875
ABSTRACT
OBJECTIVE:
Serum α-hydroxybutyrate (α-HB) is elevated in insulin resistance and diabetes. We tested the hypothesis that the α-HB level predicts abnormal 1â h glucose levels and ß-cell dysfunction inferred from plasma insulin kinetics during a 75â g oral glucose tolerance test (OGTT). RESEARCH DESIGN ANDMETHODS:
This cross-sectional study included 217 patients at increased risk for diabetes. 75â g OGTTs were performed with multiple postload glucose and insulin measurements over a 30-120â min period. OGTT responses were analyzed by repeated measures analysis of variance (ANOVA). Multivariable logistic regression was used to predict 1â h glucose ≥155â mg/dL with α-HB added to traditional risk factors.RESULTS:
Mean±SD age was 51±15â years (44% male, 25% with impaired glucose tolerance). Fasting glucose and insulin levels, but not age or body mass index (BMI), were significantly higher in the second/third α-HB tertiles (>3.9â µg/mL) than in the first tertile. Patients in the second/third α-HB tertiles exhibited a higher glucose area under the receiver operating characteristics curve (AUC) and reduced initial slope of insulin response during OGTT. The AUC for predicting 1â h glucose ≥155â mg/dL was 0.82 for a base model that included age, gender, BMI, fasting glucose, glycated hemoglobin (HbA1c), and insulin, and increased to 0.86 with α-HB added (p=0.015), with a net reclassification index of 52% (p<0.0001).CONCLUSIONS:
Fasting serum α-HB levels predicted elevated 1â h glucose during OGTT, potentially due to impaired insulin secretion kinetics. This association persisted even in patients with an otherwise normal insulin-glucose homeostasis. Measuring serum α-HB could thus provide a rapid, inexpensive screening tool for detecting early subclinical hyperglycemia, ß-cell dysfunction, and increased risk for diabetes.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
BMJ Open Diabetes Res Care
Año:
2014
Tipo del documento:
Article
País de afiliación:
Estados Unidos