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Natural history and physiological determinants of changes in glucose tolerance in a non-diabetic population: the RISC Study

Ferrannini, E.; Natali, A.; Muscelli, E.; Nilsson, Peter LU ; Golay, A.; Laakso, M.; Beck-Nielsen, H. and Mari, A. (2011) In Diabetologia 54(6). p.1507-1516
Abstract
The natural history and physiological determinants of glucose intolerance in subjects living in Europe have not been investigated. The aim of this study was to increase our understanding of this area. We analysed the data from a population-based cohort of 1,048 non-diabetic, normotensive men and women (aged 30-60 years) in whom insulin sensitivity was measured by the glucose clamp technique (M/I index; average glucose infusion rate/steady-state insulin concentration) and beta cell function was estimated by mathematical modelling of the oral glucose tolerance test at baseline and 3 years later. Seventy-seven per cent of the participants had normal glucose tolerance (NGT) and 5% were glucose intolerant both at baseline and follow up; glucose... (More)
The natural history and physiological determinants of glucose intolerance in subjects living in Europe have not been investigated. The aim of this study was to increase our understanding of this area. We analysed the data from a population-based cohort of 1,048 non-diabetic, normotensive men and women (aged 30-60 years) in whom insulin sensitivity was measured by the glucose clamp technique (M/I index; average glucose infusion rate/steady-state insulin concentration) and beta cell function was estimated by mathematical modelling of the oral glucose tolerance test at baseline and 3 years later. Seventy-seven per cent of the participants had normal glucose tolerance (NGT) and 5% were glucose intolerant both at baseline and follow up; glucose tolerance worsened in 13% (progressors) and improved in 6% (regressors). The metabolic phenotype of the latter three groups was similar (higher prevalence of familial diabetes, older age, higher waist-to-hip ratio, higher fasting and 2 h plasma glucose, higher fasting and 2 h plasma insulin, lower insulin sensitivity and reduced beta cell glucose sensitivity with increased absolute insulin secretion). Adjusting for these factors in a logistic model, progression was predicted by insulin resistance (bottom M/I quartile, OR 2.52 [95% CI 1.51-4.21]) and beta cell glucose insensitivity (bottom quartile, OR 2.39 [95% CI 1.6-3.93]) independently of waist-to-hip ratio (OR 1.44 [95% CI 1.13-1.84] for one SD). At follow up, insulin sensitivity and beta cell glucose sensitivity were unchanged in the stable NGT and stable non-NGT groups, worsened in progressors and improved in regressors. Glucose tolerance deteriorates over time in young, healthy Europids. Progressors, regressors and glucose-intolerant participants share a common baseline phenotype. Insulin sensitivity and beta cell glucose sensitivity predict and track changes in glucose tolerance independently of sex, age and obesity. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Beta cell function, Diabetes, Dysglycaemia progression, Glucose, tolerance, Insulin resistance
in
Diabetologia
volume
54
issue
6
pages
1507 - 1516
publisher
Springer Verlag
external identifiers
  • wos:000290328300029
  • scopus:80052547130
ISSN
1432-0428
DOI
10.1007/s00125-011-2112-x
language
English
LU publication?
yes
id
508e1f5e-8ddf-49f3-a148-099ceb4f0e2e (old id 1987901)
date added to LUP
2011-07-01 09:16:43
date last changed
2017-11-19 03:11:00
@article{508e1f5e-8ddf-49f3-a148-099ceb4f0e2e,
  abstract     = {The natural history and physiological determinants of glucose intolerance in subjects living in Europe have not been investigated. The aim of this study was to increase our understanding of this area. We analysed the data from a population-based cohort of 1,048 non-diabetic, normotensive men and women (aged 30-60 years) in whom insulin sensitivity was measured by the glucose clamp technique (M/I index; average glucose infusion rate/steady-state insulin concentration) and beta cell function was estimated by mathematical modelling of the oral glucose tolerance test at baseline and 3 years later. Seventy-seven per cent of the participants had normal glucose tolerance (NGT) and 5% were glucose intolerant both at baseline and follow up; glucose tolerance worsened in 13% (progressors) and improved in 6% (regressors). The metabolic phenotype of the latter three groups was similar (higher prevalence of familial diabetes, older age, higher waist-to-hip ratio, higher fasting and 2 h plasma glucose, higher fasting and 2 h plasma insulin, lower insulin sensitivity and reduced beta cell glucose sensitivity with increased absolute insulin secretion). Adjusting for these factors in a logistic model, progression was predicted by insulin resistance (bottom M/I quartile, OR 2.52 [95% CI 1.51-4.21]) and beta cell glucose insensitivity (bottom quartile, OR 2.39 [95% CI 1.6-3.93]) independently of waist-to-hip ratio (OR 1.44 [95% CI 1.13-1.84] for one SD). At follow up, insulin sensitivity and beta cell glucose sensitivity were unchanged in the stable NGT and stable non-NGT groups, worsened in progressors and improved in regressors. Glucose tolerance deteriorates over time in young, healthy Europids. Progressors, regressors and glucose-intolerant participants share a common baseline phenotype. Insulin sensitivity and beta cell glucose sensitivity predict and track changes in glucose tolerance independently of sex, age and obesity.},
  author       = {Ferrannini, E. and Natali, A. and Muscelli, E. and Nilsson, Peter and Golay, A. and Laakso, M. and Beck-Nielsen, H. and Mari, A.},
  issn         = {1432-0428},
  keyword      = {Beta cell function,Diabetes,Dysglycaemia progression,Glucose,tolerance,Insulin resistance},
  language     = {eng},
  number       = {6},
  pages        = {1507--1516},
  publisher    = {Springer Verlag},
  series       = {Diabetologia},
  title        = {Natural history and physiological determinants of changes in glucose tolerance in a non-diabetic population: the RISC Study},
  url          = {http://dx.doi.org/10.1007/s00125-011-2112-x},
  volume       = {54},
  year         = {2011},
}