Insulin sensitivity and beta-cell function assessed by C-peptide in young adults with cystic fibrosis

Aims: Despite a higher prevalence of overweight and obesity in black South African women compared to men, the prevalence of type 2 diabetes does not differ. We explored if this could be due to sex differences in insulin sensitivity, clearance and or beta cell function, and also sex-specific associations with total and regional adiposity. Methods: This cross-sectional study included 804 black South African men (n=388) and women (n=416). Dual-energy x ray absorptiometry was used to measure total and regional adiposity. Insulin sensitivity (Matsuda index), secretion (C peptide index) and clearance (C peptide/insulin ratio) were estimated from an oral glucose tolerance test. Results: After adjusting for sex differences in fat mass index, men were less insulin sensitive and had lower beta cell function than women (p<0.001), with the strength of the associations with measures of total and central adiposity being greater in men than women (p<0.001 for interactions). Further, the association between total adiposity and type 2 diabetes risk was also greater in men than women (relative risk ratio (95% confidence interval): 2.05 (1.42 to 2.96), p<0.001 vs. 1.38 (1.03 to 1.85), p=0.031). Conclusion: With increasing adiposity, particularly increased centralisation of body fat linked to decreased insulin sensitivity and beta cell function, Black African men are at greater risk for type 2 diabetes than their female counterparts.

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Glucose tolerance stages in Cystic Fibrosis are idenfied by a unique pattern of defects of Beta-cell function

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa932 ◽

2020 ◽

Author(s):

Claudia Piona ◽

Sonia Volpi ◽

Chiara Zusi ◽

Enza Mozzillo ◽

Antonella Tosco ◽

...

Keyword(s):

Cystic Fibrosis ◽

Insulin Sensitivity ◽

Glucose Tolerance ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Insulin Clearance ◽

Glucose Regulation ◽

Unique Pattern ◽

Glucose Tolerance Status

Abstract Aim To assess the order of severity of the defects of three direct determinants of glucose regulation, i.e., beta-cell function, insulin clearance and insulin sensitivity, in patients with CF categorized according their glucose tolerance status, including early elevation of mid-OGTT glucose values (>140 and < 200 mg/dL), named AGT140. Methods Two hundred and thirty-two CF patients aged 10-25 underwent OGTT. Beta-cell function and insulin clearance were estimated by OGTT mathematical modelling and OGTT-derived biomarkers of insulin secretion and sensitivity were calculated. The association between five glucose tolerance stages [NGT, AGT140, Indeterminate glucose Tolerance (INDET), impaired glucose tolerance (IGT), Cystic fibrosis related diabetes (CFRD)] and glucometabolic variables was assessed with general linear model. Results Beta-cell function and insulin sensitivity progressively worsened across glucose tolerance stages (p<0.001) with AGT140 patients significantly differing from NGT (all p<0.01). AGT140 and INDET showed a degree of beta-cell dysfunction similar to IGT and CFRD, respectively (all p<0.01). Insulin clearance was not significantly associated with glucose tolerance stages (p=0.162). Each class of glucose tolerance was uniquely identified by a specific combination of defects of the direct determinants of glucose regulation. Conclusions In CF patients each of the five glucose tolerance stages shows a unique pattern of defects of the direct determinants of glucose regulation, with AGT140 patients significantly differing from NGT and being similar to IGT. These findings suggest to recognize AGT 140 as a distinct glucose tolerance class and to reconsider the grade of glucometabolic deterioration across glucose tolerance stages in CF.

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223-LB: Beta-Cell Function but Not Insulin Sensitivity Is Impaired in Nondiabetic Cystic Fibrosis Adults Assessed with the Oral Minimal Model Method

Diabetes ◽

10.2337/db19-223-lb ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 223-LB

Author(s):

MICHELE SCHIAVON ◽

GIANNA MARIA TOFFOLO ◽

CLAUDIO COBELLI ◽

K. SREEKUMARAN NAIR ◽

ANTOINETTE MORAN

Keyword(s):

Cystic Fibrosis ◽

Insulin Sensitivity ◽

Beta Cell ◽

Minimal Model ◽

Beta Cell Function ◽

Cell Function ◽

Model Method ◽

Oral Minimal Model

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Month-Long Fish Protein Diet Improves Insulin Sensitivity, Beta-Cell Function

Clinical Endocrinology News ◽

10.1016/s1558-0164(06)70415-1 ◽

2006 ◽

Vol 1 (12) ◽

pp. 4

Author(s):

Miriam E. Tucker

Keyword(s):

Insulin Sensitivity ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Protein Diet ◽

Fish Protein

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Effect of troglitazone on insulin sensitivity and pancreatic beta-cell function in women at high risk for NIDDM

Diabetes ◽

10.2337/diabetes.45.11.1572 ◽

1996 ◽

Vol 45 (11) ◽

pp. 1572-1579 ◽

Cited By ~ 19

Author(s):

K. Berkowitz ◽

R. Peters ◽

S. L. Kjos ◽

J. Goico ◽

A. Marroquin ◽

...

Keyword(s):

Insulin Sensitivity ◽

High Risk ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Pancreatic Beta Cell ◽

Pancreatic Beta Cell Function

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Glycemia, Beta-Cell Function and Sensitivity to Insulin in Mildly to Critically Ill Covid-19 Patients

Medicina ◽

10.3390/medicina57010068 ◽

2021 ◽

Vol 57 (1) ◽

pp. 68 ◽

Cited By ~ 1

Author(s):

Ioannis Ilias ◽

Aristidis Diamantopoulos ◽

Maria Pratikaki ◽

Efthymia Botoula ◽

Edison Jahaj ◽

...

Keyword(s):

Insulin Secretion ◽

Beta Cell ◽

Critically Ill ◽

Beta Cell Function ◽

Cell Function ◽

Model Assessment ◽

Secondary Diabetes ◽

C Peptide ◽

Number Of Patients ◽

Patients With Diabetes

Background and objectives: Critically and non-critically ill patients with SARS-CoV-2 infection (Covid-19) may present with higher-than-expected glycemia, even in the absence of diabetes. With this study we aimed to assess glucose, glycemic gap (GlyG) and insulin secretion/sensitivity measures in patients with Covid-19. Materials and Methods: We studied, upon admission, 157 patients with Covid-19 (84: in wards and 73: in intensive care units; ICU); 135 had no history of diabetes. We measured blood glucose upon admission as well as glycated hemoglobin (A1c), plasma insulin and C-peptide. We calculated the GlyG and the Homeostasis Model Assessment 2 (HOMA2) estimates of steady state beta cell function (HOMA2%B) and insulin sensitivity (HOMA2%S). Statistical assessment was done with analysis or the Kruskal-Wallis test. Results: Compared to patients in the wards without diabetes, patients with diabetes in the wards, as well as patients in the ICU (without or with diabetes) had higher admission glycemia. The GlyG was significantly higher in patients without diabetes in the ICU compared to patients without diabetes in the wards, while HOMA2%B based on glucose and insulin was significantly higher in the ICU patients compared to patients in the wards. Of all the parameters, HOMA2%S based on C-peptide/glucose was higher in survivors (n = 133). Conclusions: In our series of patients with Covid-19, a substantial number of patients with and without diabetes had admission hyperglycemia and those who were critically ill may have had compromised insulin secretion and lowered sensitivity to insulin. These findings lend credence to reports of association between Covid-19 and hyperglycemia/secondary diabetes.

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Disposition index identifies defective beta-cell function in cystic fibrosis subjects with normal glucose tolerance

Journal of Cystic Fibrosis ◽

10.1016/j.jcf.2014.06.004 ◽

2015 ◽

Vol 14 (1) ◽

pp. 135-141 ◽

Cited By ~ 11

Author(s):

L. Merjaneh ◽

Q. He ◽

Q. Long ◽

L.S. Phillips ◽

A.A. Stecenko

Keyword(s):

Cystic Fibrosis ◽

Glucose Tolerance ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function ◽

Normal Glucose Tolerance ◽

Disposition Index ◽

Normal Glucose

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Four-Year Follow-Up of Glucose Tolerance and Beta-Cell Function in Nondiabetic Cystic Fibrosis Patients

Hormone Research ◽

10.1159/000184591 ◽

1995 ◽

Vol 44 (2) ◽

pp. 45-50 ◽

Cited By ~ 13

Author(s):

F. De Luca ◽

T. Arrigo ◽

A. Di Benedetto ◽

A. Tedeschi ◽

C. Sferlazzas ◽

...

Keyword(s):

Cystic Fibrosis ◽

Glucose Tolerance ◽

Beta Cell ◽

Beta Cell Function ◽

Cell Function

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Pancreatic beta-cell function and glucose metabolism in human segmental pancreas and kidney transplantation

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.1993.264.3.e441 ◽

1993 ◽

Vol 264 (3) ◽

pp. E441-E449 ◽

Cited By ~ 2

Author(s):

E. Christiansen ◽

H. B. Andersen ◽

K. Rasmussen ◽

N. J. Christensen ◽

K. Olgaard ◽

...

Keyword(s):

Insulin Secretion ◽

Glucose Metabolism ◽

Beta Cell ◽

Kidney Transplant ◽

Beta Cell Function ◽

Cell Function ◽

Pancreatic Beta Cell ◽

Secretion Rate ◽

C Peptide ◽

Insulin Secretion Rate

beta-Cell function and glucose metabolism were studied in eight insulin-dependent diabetic recipients of combined segmental pancreas and kidney transplant with peripheral insulin delivery (Px), in eight nondiabetic kidney-transplant individuals (Kx), and in eight normal subjects (Ns) after three consecutive mixed meals. All subjects had normal fasting plasma glucose, but increased basal levels of C-peptide were demonstrated in the transplant groups (P < 0.05 relative to Ns). Postprandial hyperglycemia was increased 14% in Kx and 32% in Px (P < 0.05), whereas compared with Ns postprandial C-peptide levels were increased three- and twofold, respectively, in Kx and Px (P < 0.05). Compared with Ns basal insulin secretion rate (combined model) was increased 2-fold in Kx and 1.4-fold in Px (P < 0.05). Maximal insulin secretion rate was reduced 25% in Px compared with Kx (P < 0.05) but not different from that of Ns (P NS). Also, maximal insulin secretion rate occurred later in Px than in controls (Tmax: Px 50 min, Kx 30 min, and Ns 32 min; P < 0.05). The total integrated insulin secretion was increased 1.4-fold in Px compared with Ns (P < 0.05) but decreased 1.4-fold compared with Kx (P < 0.05). Fasting and postprandial proinsulin-to-C-peptide molar ratios were inappropriately increased in Px compared with Kx and Ns. Basal hepatic glucose production was increased 43% in Px and 33% in Kx compared with Ns (P < 0.05). Postprandial total systemic glucose appearance was similar in all three groups, whereas peripheral glucose disposal was 15% reduced in Px (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

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