Differences in insulin resistance and pancreatic B-cell function in obese subjects with isolated impaired glucose tolerance and isolated impaired fasting glucose

ObjectiveImpaired fasting glucose (IFG) and impaired glucose tolerance (IGT) may convey disparate risks of metabolic consequences. Fasting plasma glucose (FPG), while an expedient screening procedure, may not adequately assess metabolic risk, particularly among youths. In order to inform a strategy for screening Chinese youth for pre-diabetes, we examined the relative value of IFG versus IGT to define metabolic risk by assessing their association with insulin resistance, beta-cell dysfunction, adverse adipokine profiles and other cardiometabolic risk factors.Research design and methodsWe recruited 542 subjects (age 14–28 years) from the Beijing Child and Adolescent Metabolic Syndrome study for an in-depth assessment of cardiometabolic risk factors, including a 2-hour oral glucose tolerance test, liver ultrasound and serum levels of four adipokines.ResultsFPG failed to identify nearly all (32/33) youths with IGT, whereas 2-hour plasma glucose (2 h PG) missed 80.8% (21/26) of subjects with IFG. Impaired beta-cell function was evident from decreased oral disposition indices in those with isolated impaired fasting glucose (iIFG) or isolated impaired glucose tolerance (iIGT) versus normal glucose tolerance (NGT) (all p<0.001), whereas reduced insulin sensitivity (Matsuda) index was most pronounced in the iIGT group (p<0.01). Moreover, alterations in adipokine levels (fibroblast growth factor 21, adiponectin and leptin/adiponectin ratio) were associated with iIGT (p<0.05) but not iIFG. Youths with iIGT had a 2-fold to 32-fold increased incidence of hypertriglyceridemia, hypertension and metabolic syndrome (MetS) compared with those with NGT. In addition, subgroup analyses of participants with normal FPG revealed that the odds of having IGT increased 3-fold to 18-fold among those with elevated TGs, hypertension, moderate-to-severe non-alcoholic fatty liver disease or MetS.ConclusionsChinese youth with iIGT exhibit a higher cardiometabolic risk profile than those with iIFG. Thus, 2 h PG is preferred over FPG to identify the pre-diabetes phenotype at greatest risk of subsequent development of cardiovascular disease.Trial registration numberNCT03421444.

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Quantitative Linkage Analysis for Pancreatic B-cell Function and Insulin Resistance in a Large Twin Cohort

Diabetes ◽

10.2337/db07-0708 ◽

2008 ◽

Vol 57 (4) ◽

pp. 1120-1124 ◽

Cited By ~ 10

Author(s):

M. Falchi ◽

S. G. Wilson ◽

D. Paximadas ◽

R. Swaminathan ◽

T. D. Spector

Keyword(s):

Insulin Resistance ◽

Linkage Analysis ◽

B Cell ◽

Cell Function ◽

Pancreatic B Cell ◽

B Cell Function

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The positive association between serum uric acid, impaired fasting glucose, impaired glucose tolerance, and diabetes mellitus in the ELSA-Brasil study

Cadernos de Saúde Pública ◽

10.1590/0102-311x00255920 ◽

2021 ◽

Vol 37 (9) ◽

Author(s):

Aline Isabel Rodrigues Galvão ◽

Alline Maria R. Beleigoli ◽

Pedro Guatimosim Vidigal ◽

Bruce Bartholow Duncan ◽

Maria Inês Schmidt ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Uric Acid ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Serum Uric Acid ◽

Impaired Fasting Glucose ◽

Fasting Glucose ◽

Newly Diagnosed ◽

Glycemic Status

Abstract: There is a conflict in the literature regarding the association between serum uric acid (SUA) levels and glycemic status. Therefore, we evaluated the association between SUA level and glycemic status - impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes mellitus - and insulin resistance, in a large Brazilian study. This is a cross-sectional, observational study with 13,207 participants aged 35-74 years, at baseline (2008-2010) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). A multinomial regression analysis was performed to test the association between SUA and glycemic status (IFG, IGT, and newly diagnosed type 2 diabetes at the cohort baseline) after adjustments by age, sex, skin color, body mass index, physical activity, smoking, alcohol consumption, comorbidities, and medicines use. Logistic regression model was used to evaluate the association between SUA and insulin resistance by HOMA-IR. Stratified analyses by sex were performed. The mean age (standard deviation) was 51.4 (8.9) years, 55.2% of participants were women. There were 1,439 newly diagnosed diabetes. After all adjustments, higher SUA was associated with IFG, IGT, and diabetes, with odds ratio (OR) = 1.15 (95%CI: 1.06; 1.25), 1.23 (95%CI: 1.14; 1.33), and 1.37 (95%CI: 1.24; 1.51), respectively. There was association between SUA levels and insulin resistance with OR = 1.24 (95%CI: 1.13; 1.36). In analysis stratified by sex, higher SUA persisted independently associated with impaired glycemic status. Our results suggest that a higher SUA levels were significantly associated with glycemic status in a large Latin American population, mainly among women.

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Effect of nicotinic acid-induced insulin resistance on pancreatic B cell function in normal and streptozocin-treated baboons.

Journal of Clinical Investigation ◽

10.1172/jci115145 ◽

1991 ◽

Vol 87 (4) ◽

pp. 1395-1401 ◽

Cited By ~ 26

Author(s):

D K McCulloch ◽

S E Kahn ◽

M W Schwartz ◽

D J Koerker ◽

J P Palmer

Keyword(s):

Insulin Resistance ◽

Nicotinic Acid ◽

B Cell ◽

Cell Function ◽

Pancreatic B Cell ◽

B Cell Function

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Differences in Insulin Resistance in Nondiabetic Subjects With Isolated Impaired Glucose Tolerance or Isolated Impaired Fasting Glucose

Diabetes ◽

10.2337/diabetes.53.6.1549 ◽

2004 ◽

Vol 53 (6) ◽

pp. 1549-1555 ◽

Cited By ~ 125

Author(s):

A. Festa ◽

R. D'Agostino ◽

A. J.G. Hanley ◽

A. J. Karter ◽

M. F. Saad ◽

...

Keyword(s):

Insulin Resistance ◽

Glucose Tolerance ◽

Impaired Glucose Tolerance ◽

Impaired Fasting Glucose ◽

Fasting Glucose

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Effect of exercise on insulin action, glucose tolerance, and insulin secretion in aging

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.1990.258.6.e937 ◽

1990 ◽

Vol 258 (6) ◽

pp. E937-E943 ◽

Cited By ~ 28

Author(s):

S. E. Kahn ◽

V. G. Larson ◽

J. C. Beard ◽

K. C. Cain ◽

G. W. Fellingham ◽

...

Keyword(s):

Insulin Sensitivity ◽

Exercise Training ◽

Glucose Tolerance ◽

B Cell ◽

Cell Function ◽

Fasting Glucose ◽

Oral Glucose ◽

Intravenous Glucose ◽

B Cell Function ◽

Intravenous Glucose Tolerance

To assess the effect of exercise training on the insulin resistance and impaired pancreatic B-cell function of aging, we studied 13 healthy older men (ages 61-82 yr) before and after 6 mo intensive endurance exercise. An index of insulin sensitivity (SI) was measured using Bergman's minimal model. Intravenous glucose tolerance was quantified using the glucose disappearance constant (KGlc) while oral glucose tolerance was assessed after a 100-g glucose load. B-cell function was evaluated by measuring the acute insulin response (AIR) to glucose injection at fasting glucose (AIRGlc) and the AIR to arginine at multiple clamped glucose levels. Exercise produced an endurance training effect as demonstrated by an 18% increase in maximum O2 consumption (VO2max) [38.2 +/- 1.4 to 45.0 +/- 1.1 (SE) ml.kg fat-free mass-1.min-1, P less than 0.001]. An unchanged fasting glucose (5.3 +/- 0.2 to 5.4 +/- 0.2 mM) despite a reduced fasting insulin (61 +/- 6 to 48 +/- 6 pM, P less than 0.01) suggested exercise training improved insulin sensitivity. This was confirmed by a 36% increase in SI from 3.47 +/- 0.41 to 4.71 +/- 0.42 x 10(-5) min-1/pM (P = 0.01). Intravenous glucose tolerance did not change as measured by KGlc, which was 1.46 +/- 0.09 before and 1.48 +/- 0.16%/min after exercise training. Likewise, the incremental glucose response to oral glucose (633 +/- 49-618 +/- 45 mM.min) was unchanged. B-cell function was decreased as reflected by AIRGlc (351 +/- 73-245 +/- 53 pM, P less than 0.01) and the AIRArg at maximal glycemic potentiation (AIRmax, 1,718 +/- 260-1,228 +/- 191 pM, P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

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