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Comparison of composite whole body insulin sensitivity index derived from mixed meal test and oral glucose tolerance test in insulin resistant obese subjects

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Abstract

Apart from fasting blood glucose (FBG) and insulin (FBI), oral glucose tolerance test (OGTT) is also used in calculating insulin sensitivity. During OGTT, insulin secretion may not reflect normal physiological insulin secretion. Based on this idea, hepatic and whole body insulin sensitivity rates were tested during OGTT and mixed meal test (MMT) in obese subjects. Thirty-one women with Quantitative Insulin Sensitivity Check Index (QUICKI) values below 0.350 and body mass index (BMI) ≥30 were included into the study. OGTT with 75-g glucose and MMT 300 kcal were applied to all cases. Data obtained from OGTT and MMT were used in the assessment of insulin sensitivity with Hemostasis of Model Assessment-Insulin Resistance (HOMA-IR) and Matsuda’s Composite Whole Body Insulin Sensitivity Index (Matsuda’s ISI). Mean BMI, FBG, and FBI were 36.8 ± 3.9 kg/m2, 100.5 ± 0.10 mg/dl, 16.2 ± 5.3 μg/ml, respectively. QUICKI was 0.31 ± 0.01 and HOMA-IR was 3.71 ± 0.88. Matsuda’s ISI derived from OGTT was 6.96 ± 3.35 and from MMT was 11.32 ± 6.61. In analysis, it was demonstrated that there was a correlation between HOMA-IR, QUICKI, and Matsuda’s ISIs derived from OGTT and MMT. Comparing the time periods separately, it was detected that despite similar increment in insulin levels, glucose levels were higher in OGTT than MMT at 15 and 30 min. Consequently, Matsuda’s ISI was demonstrated to be effectively used with the data of MMT, as used with OGTT. Moreover, MMT was shown to be in parallel to physiologic insulin secretion and reflect pancreatic functions better compared to OGTT.

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References

  1. E.S. Ford, Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence. Diabetes Care 28, 1769–1778 (2005)

    Article  PubMed  Google Scholar 

  2. H.E. Lebovitz, Clinician’s manual of insulin resistance (Science Press, London, 2002), pp. 1–15

    Google Scholar 

  3. W.C. Knowler, E. Barrett-Connor, S.E. Fowler, R.F. Hamman, J.M. Lachin, E.A. Walker, D.M. Nathan, Diabetes Prevention Research Group: reduction in the incidence of type 2 diabetes with life style intervention or metformin. N. Eng. J. Med. 346, 393–403 (2002)

    Article  CAS  Google Scholar 

  4. T.A. Buchanan, A.H. Xiang, R.K. Peters, S.L. Kjos, A. Marroquin, J. Goico, C. Ochoa, S. Tan, K. Berkowitz, H.N. Hodis, S.P. Azen, Preservation of pancreatic beta-cell function and prevention of type 2 diabetes by pharmacological treatment of insulin resistance in high-risk hispanic women. Diabetes 51, 2796–2803 (2002)

    Article  CAS  PubMed  Google Scholar 

  5. L.C. Groop, R.C. Bonadonna, M. Shank, A.S. Petrides, R.A. DeFronzo, Role of free fatty acids and insulin in determining free fatty acids and lipid oxidation in man. J. Clin. Invest. 87, 83–89 (1991)

    Article  CAS  PubMed  Google Scholar 

  6. R.A. DeFronzo, J.D. Tobin, R. Andres, Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am. J. Physiol. 237, E214–E223 (1979)

    CAS  PubMed  Google Scholar 

  7. A. Katz, S.S. Nambi, K. Mather, A.D. Baron, D.A. Follmann, G. Sullivan, M.J. Quon, Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J. Clin. Endocrinol. Metab. 85, 2402–2410 (2000)

    Article  CAS  PubMed  Google Scholar 

  8. D. Matthews, J. Hosker, A.S. Rudenski, B.A. Naylor, D.F. Treacher, R.C. Turner, Homeostasis model assessment: insulin resistance and beta cell function from fasting plasma glucose and insulin concentration in man. Diabetologia 28, 412–419 (1985)

    Article  CAS  PubMed  Google Scholar 

  9. M. Matsuda, R.A. DeFronzo, Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 22, 1462–1470 (1999)

    Article  CAS  PubMed  Google Scholar 

  10. M. Stumvoll, A. Mitrakuo, W. Pirnenta, T. Jenssen, H. Yki-Yarvinen, T. Van Haeften, W. Renn, J. Gerich, Use of the oral glucose tolerance test to assess insulin release and insulin sensitivity. Diabetes Care 23, 295–301 (2000)

    Article  CAS  PubMed  Google Scholar 

  11. M.A. Abdul-Ghani, M. Matsuda, B. Balas, R.A. DeFronzo, Muscle and liver insulin resistance indexes derived from the oral glucose tolerance test. Diabetes Care 30, 89–94 (2007)

    Article  CAS  PubMed  Google Scholar 

  12. M.A. Abdul-Ghani, K. Williams, R.A. DeFronzo, M. Stern, What is the best predictor of future type 2 diabetes? Diabetes Care 30, 1544–1548 (2007)

    Article  PubMed  Google Scholar 

  13. M. Stumvoll, A. Fritsche, H. Haring, The OGTT as test for beta cell function? Eur. J. Clin. Invest. 31, 380–381 (2001)

    Article  CAS  PubMed  Google Scholar 

  14. W. Creutzfeldt, M. Nauck, Gut hormones and diabetes mellitus. Diabetes Metab. Rev. 8, 149–177 (1992)

    Article  CAS  PubMed  Google Scholar 

  15. F. Preitner, M. Ibberson, I. Franklin, C. Binnert, M. Pende, A. Gjinovci, T. Hansotia, D.J. Drucker, C. Wollheim, R. Burcelin, B. Thorens, Gluco-incretins control insulin secretion at multiple levels as revealed in mice lacking GLP-1 and GIP receptors. J. Clin. Invest. 113, 635–645 (2004)

    CAS  PubMed  Google Scholar 

  16. P. Newsholme, L. Brennan, B. Rubi, P. Maechler, New insights into amino acid metabolism, β-cell function and diabetes. Clin. Sci. (Lond) 108, 185–194 (2005)

    Article  CAS  Google Scholar 

  17. S. Bolea, J.A. Pertusa, F. Martin, J.V. Sanchez-Andres, B. Soria, Regulation of pancreatic β-cell electrical activity and insulin release by physiological amino acid concentrations. Pflugers Arch. 433, 699–704 (1997)

    Article  CAS  PubMed  Google Scholar 

  18. N. Berthiaume, B.A. Zinker, Metabolic responses in a model of insulin resistance: comparison between oral glucose and meal tolerance tests. Metabolisms 51, 595–598 (2002)

    CAS  Google Scholar 

  19. I.R. Jones, D.R. Ovens, S. Luzio, S. Williams, T.M. Hayes, The glucose dependent insulinotropic polypeptide response to oral glucose and mixed meals is increased in patients in type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 32, 668–677 (1989)

    Article  CAS  PubMed  Google Scholar 

  20. S. Marena, G. Montegrosso, F. De Michieli, E. Pisu, G. Pagano, Comparison of the metabolic effects of mixed meal and standard oral glucose tolerance test on glucose, insulin and C-peptide response in healthy, impaired glucose tolerance, mild and severe non-insulin-dependent diabetic subjects. Acta Diabetol. 29, 29–33 (1992)

    Article  CAS  PubMed  Google Scholar 

  21. C. Dalla Man, A. Caumo, R. Basu, R. Rizza, G. Toffolo, C. Cobelli, Minimal model estimation of glucose absorbtion and insulin sensitivity from oral test: validation with a tracer method. Am. J. Physiol. Endocrinol. Metab. 287, E637–E643 (2004)

    Article  CAS  PubMed  Google Scholar 

  22. P.J. Campbell, L.J. Mandarino, J.E. Gerich, Quantification of the relative impairment in actions of insulin on hepatic glucose production and peripheral glucose uptake in non-insulin-dependent diabetes mellitus. Metabolism 37, 15–21 (1988)

    Article  CAS  PubMed  Google Scholar 

  23. J. Dupre, Glycaemic effects of incretins in type 1 diabetes mellitus: a concise review, with emphasis on studies in humans. Regul. Pept. 128, 149–157 (2005)

    Article  CAS  PubMed  Google Scholar 

  24. American Diabetes Association, Diagnosis and classification of diabetes mellitus. Diabetes Care 32(Suppl 1), S62–S67 (2009)

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Division of Endocrinology, Malatya State Hospital, Malatya, Turkey

    Hadi Selimoglu

  2. Division of Endocrinology and Metabolism, Konya Education and Research Hospital, Meram Yeni Yol, 42100, Meram, Konya, Turkey

    Cevdet Duran

  3. Division of Endocrinology, Faculty of Medicine, Uludağ University, Bursa, Turkey

    Sinem Kiyici, Metin Guclu, Canan Ersoy, Erdinc Erturk, Ercan Tuncel & Sazi Imamoglu

  4. Department of Biostatistic, Faculty of Medicine, Uludağ University, Bursa, Turkey

    Guven Ozkaya

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  1. Hadi Selimoglu
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Correspondence to Cevdet Duran.

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Selimoglu, H., Duran, C., Kiyici, S. et al. Comparison of composite whole body insulin sensitivity index derived from mixed meal test and oral glucose tolerance test in insulin resistant obese subjects. Endocr 36, 299–304 (2009). https://doi.org/10.1007/s12020-009-9213-z

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  • DOI: https://doi.org/10.1007/s12020-009-9213-z

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