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Hepatic insulin clearance is closely related to metabolic syndrome components
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Pivovarova, Olga, Bernigau, Wolfgang, Bobbert, Thomas, Isken, Frank, Möhlig, Matthias, Spranger, Joachim, Weickert, Martin O., Osterhoff, Martin, Pfeiffer, Andreas F. H. and Rudovich, Natalia N. (2013) Hepatic insulin clearance is closely related to metabolic syndrome components. Diabetes Care, Volume 36 (Number 11). pp. 3779-3785. doi:10.2337/dc12-1203 ISSN 0149-5992.
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Official URL: http://dx.doi.org/10.2337/dc12-1203
Abstract
OBJECTIVE Insulin clearance is decreased in type 2 diabetes mellitus (T2DM) for unknown reasons. Subjects with metabolic syndrome are hyperinsulinemic and have an increased risk of T2DM. We aimed to investigate the relationship between hepatic insulin clearance (HIC) and different components of metabolic syndrome and tested the hypothesis that HIC may predict the risk of metabolic syndrome.
RESEARCH DESIGN AND METHODS Individuals without diabetes from the Metabolic Syndrome Berlin Brandenburg (MeSyBePo) study (800 subjects with the baseline examination and 189 subjects from the MeSyBePo recall study) underwent an oral glucose tolerance test (OGTT) with assessment of insulin secretion (insulin secretion rate [ISR]) and insulin sensitivity. Two indices of HIC were calculated.
RESULTS Both HIC indices showed lower values in subjects with metabolic syndrome (P < 0.001) at baseline. HIC indices correlate inversely with waist circumference, diastolic blood pressure, fasting glucose, triglycerides, and OGTT-derived insulin secretion index. During a mean follow-up of 5.1 ± 0.9 years, 47 individuals developed metabolic syndrome and 33 subjects progressed to impaired glucose metabolism. Both indices of HIC showed a trend of an association with increased risk of metabolic syndrome (HICC-peptide odds ratio 1.13 [95% CI 0.97–1.31], P = 0.12, and HICISR 1.38 [0.88–2.17], P = 0.16) and impaired glucose metabolism (HICC-peptide 1.12 [0.92–1.36], P = 0.26, and HICISR 1.31 [0.74–2.33] P = 0.36), although point estimates reached no statistical significance.
CONCLUSIONS HIC was associated with different components of metabolic syndrome and markers of insulin secretion and insulin sensitivity. Decreased HIC may represent a novel pathophysiological mechanism of the metabolic syndrome, which may be used additionally for early identification of high-risk subjects.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Diabetes Care | ||||
| Publisher: | American Diabetes Association | ||||
| ISSN: | 0149-5992 | ||||
| Official Date: | 2013 | ||||
| Dates: |
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| Volume: | Volume 36 | ||||
| Number: | Number 11 | ||||
| Page Range: | pp. 3779-3785 | ||||
| DOI: | 10.2337/dc12-1203 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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