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Nonsuppressed glucagon after glucose challenge as a potential predictor for glucose tolerance

Wagner, Róbert; Hakaste, Liisa H.; Ahlqvist, Emma LU ; Heni, Martin; Machann, Jürgen; Schick, Fritz; Van Obberghen, Emmanuel; Stefan, Norbert; Gallwitz, Baptist and Tuomi, Tiinamaija LU , et al. (2017) In Diabetes 66(5). p.1373-1379
Abstract

Glucagon levels are classically suppressed after glucose challenge. It is still not clear as to whether a lack of suppression contributes to hyperglycemia and thus to the development of diabetes. We investigated the association of postchallenge change in glucagon during oral glucose tolerance tests (OGTTs), hypothesizing that higher postchallenge glucagon levels are observed in subjects with impaired glucose tolerance (IGT). Glucagon levels were measured during OGTT in a total of 4,194 individuals without diabetes in three large European cohorts. Longitudinal changes in glucagon suppression were investigated in 50 participants undergoing a lifestyle intervention. Only 66-79% of participants showed suppression of glucagon at 120 min... (More)

Glucagon levels are classically suppressed after glucose challenge. It is still not clear as to whether a lack of suppression contributes to hyperglycemia and thus to the development of diabetes. We investigated the association of postchallenge change in glucagon during oral glucose tolerance tests (OGTTs), hypothesizing that higher postchallenge glucagon levels are observed in subjects with impaired glucose tolerance (IGT). Glucagon levels were measured during OGTT in a total of 4,194 individuals without diabetes in three large European cohorts. Longitudinal changes in glucagon suppression were investigated in 50 participants undergoing a lifestyle intervention. Only 66-79% of participants showed suppression of glucagon at 120 min (fold change glucagon120/0 <1) during OGTT, whereas 21-34% presented with increasing glucagon levels (fold change glucagon120/0 ≥1). Participants with nonsuppressed glucagon120 had a lower risk of IGT in all cohorts (odds ratio 0.44-0.53, P < 0.01). They were also leaner and more insulin sensitive and had lower liver fat contents. In the longitudinal study, an increase of fold change glucagon120/0 was associated with an improvement in insulin sensitivity (P = 0.003). We characterize nonsuppressed glucagon120 during the OGTT. Lower glucagon suppression after oral glucose administration is associated with a metabolically healthier phenotype, suggesting that it is not an adverse phenomenon.

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publication status
published
subject
in
Diabetes
volume
66
issue
5
pages
7 pages
publisher
American Diabetes Association
external identifiers
  • scopus:85019394857
  • wos:000399799800030
ISSN
0012-1797
DOI
10.2337/db16-0354
language
English
LU publication?
yes
id
2d332b54-16ea-4e18-a092-0e601d10da9e
date added to LUP
2017-06-08 17:06:25
date last changed
2017-09-18 11:39:54
@article{2d332b54-16ea-4e18-a092-0e601d10da9e,
  abstract     = {<p>Glucagon levels are classically suppressed after glucose challenge. It is still not clear as to whether a lack of suppression contributes to hyperglycemia and thus to the development of diabetes. We investigated the association of postchallenge change in glucagon during oral glucose tolerance tests (OGTTs), hypothesizing that higher postchallenge glucagon levels are observed in subjects with impaired glucose tolerance (IGT). Glucagon levels were measured during OGTT in a total of 4,194 individuals without diabetes in three large European cohorts. Longitudinal changes in glucagon suppression were investigated in 50 participants undergoing a lifestyle intervention. Only 66-79% of participants showed suppression of glucagon at 120 min (fold change glucagon<sub>120/0</sub> &lt;1) during OGTT, whereas 21-34% presented with increasing glucagon levels (fold change glucagon<sub>120/0</sub> ≥1). Participants with nonsuppressed glucagon120 had a lower risk of IGT in all cohorts (odds ratio 0.44-0.53, P &lt; 0.01). They were also leaner and more insulin sensitive and had lower liver fat contents. In the longitudinal study, an increase of fold change glucagon<sub>120/0</sub> was associated with an improvement in insulin sensitivity (P = 0.003). We characterize nonsuppressed glucagon<sub>120</sub> during the OGTT. Lower glucagon suppression after oral glucose administration is associated with a metabolically healthier phenotype, suggesting that it is not an adverse phenomenon.</p>},
  author       = {Wagner, Róbert and Hakaste, Liisa H. and Ahlqvist, Emma and Heni, Martin and Machann, Jürgen and Schick, Fritz and Van Obberghen, Emmanuel and Stefan, Norbert and Gallwitz, Baptist and Tuomi, Tiinamaija and Häring, Hans Ulrich and Groop, Leif and Fritsche, Andreas},
  issn         = {0012-1797},
  language     = {eng},
  month        = {05},
  number       = {5},
  pages        = {1373--1379},
  publisher    = {American Diabetes Association},
  series       = {Diabetes},
  title        = {Nonsuppressed glucagon after glucose challenge as a potential predictor for glucose tolerance},
  url          = {http://dx.doi.org/10.2337/db16-0354},
  volume       = {66},
  year         = {2017},
}