Insulin secretion, obesity, and potential behavioral influences: results from the Insulin Resistance Atherosclerosis Study (IRAS)

Mayer‐Davis, Elizabeth J.; Levin, Sarah; Bergman, Richard N.; D’Agostino, Ralph B.; Karter, Andrew J.; Saad, Mohammed F.

doi:10.1002/dmrr.185

Cited by 28 publications

(19 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The biological mechanism underlying the association between MetS and ␤-cell dysfunction may be related to the fact that a number of MetS components, including elevated abdominal obesity and triglyceride concentration and reduced HDL levels, are strongly correlated with elevated circulating concentrations of free fatty acids (47), chronic elevations of which are known to be associated with lipotoxic damage to the pancreatic ␤-cells (48). This hypothesis is consistent with results from a previous study using IRAS data, in which it was reported that elevated waist circumference was significantly associated with reduced DI (49). The notably strong association of NCEPMetS with reduced IS among blacks suggests the possibility that NCEP-MetS may be an especially useful predictor of diabetes in this ethnic group.…”

Section: Discussionsupporting

confidence: 92%

Identification of Subjects with Insulin Resistance and β-Cell Dysfunction Using Alternative Definitions of the Metabolic Syndrome

et al. 2003

View full text Add to dashboard Cite

Recently, the metabolic syndrome (MetS) has attracted much attention as a risk cluster for cardiovascular disease. Although it is believed that individuals with the MetS have insulin resistance (IR), there are few data using direct measures of IR such as glucose clamps or frequently sampled intravenous glucose tolerance tests (FSIGTTs). We examined associations of MetS with FSIGTT-derived measures of insulin sensitivity and secretion among nondiabetic subjects in the Insulin Resistance Atherosclerosis Study. Two sets of MetS criteria were evaluated: those from the 1999 World Health Organization (WHO) and the 2001 National Cholesterol Education Program (NCEP). Both WHO and NCEP MetS definitions were significantly associated with risk of being in the lowest quartile of directly measured insulin sensitivity (P < 0.0001 for all subjects as well as within ethnic subgroups). However, the associations with WHO-MetS were stronger for all subjects combined (WHO: odds ratio [OR] ‫؍‬ 10.2; 95% CI 7.5-13.9; NCEP: OR ‫؍‬ 4.6; 3.4 -6.2) and in separate analyses of nonHispanic whites, blacks, and Hispanics. WHO and NCEP MetS definitions were also significantly associated with risk of being in the lowest quartile of insulin sensitivity-adjusted acute insulin response (AIR) and disposition index (DI; all P < 0.01), although the associations were generally weaker than those for insulin sensitivity and there was no difference between the two definitions in all subjects combined (low AIR, WHO: OR ‫؍‬ 1.7, 1.2-2.4; NCEP: OR ‫؍‬ 1.7, 1.2-2.5). There were, however, a number of ethnic differences, including a stronger association of NCEP-MetS with low AIR among blacks. WHO-MetS was significantly more sensitive than NCEPMetS in detecting low insulin sensitivity (65.4 vs. 45.6%, respectively; P < 0.0001), with no significant differences in specificity between the definitions (84.4 vs.84.6%; P ‫؍‬ 0.91), although WHO-MetS had a larger area under the receiver operating characteristic curve (75% vs. 65%; P < 0.0001). In conclusion, although both the WHO and NCEP MetS criteria identify nondiabetic individuals with low insulin sensitivity, the associations were notably stronger using the WHO definition. The definitions are generally less useful for identifying those with low AIR or DI, although NCEP-MetS seems to differentiate black subjects with insulin secretion defects.

show abstract

Section: Discussionsupporting

confidence: 92%

Identification of Subjects with Insulin Resistance and β-Cell Dysfunction Using Alternative Definitions of the Metabolic Syndrome

et al. 2003

View full text Add to dashboard Cite

show abstract

“…No association of glycemic index, glycemic load, or carbohydrates was observed with AIR or disposition index. Previous work in our population on alcohol intake, fat intake, and physical activity similarly reported no impact of these behavioral factors on AIR or disposition index (31). A recent intervention study, however, observed a significant improvement in disposition index among individuals with impaired glucose tolerance randomized to a high-carbohydrate, low-glycemic index diet (32).…”

Section: Discussionmentioning

confidence: 58%

Dietary Glycemic Index and Glycemic Load, Carbohydrate and Fiber Intake, and Measures of Insulin Sensitivity, Secretion, and Adiposity in the Insulin Resistance Atherosclerosis Study

et al. 2005

Self Cite

View full text Add to dashboard Cite

OBJECTIVE -We studied the association of digestible carbohydrates, fiber intake, glycemic index, and glycemic load with insulin sensitivity (S I ), fasting insulin, acute insulin response (AIR), disposition index, BMI, and waist circumference.RESEARCH DESIGN AND METHODS -Data on 979 adults with normal (67%) and impaired (33%) glucose tolerance from the Insulin Resistance Atherosclerosis Study (1992)(1993)(1994) were analyzed. Usual dietary intake was assessed via a 114-item interviewer-administered food frequency questionnaire from which nutrient intakes were estimated. Published glycemic index values were assigned to food items and average dietary glycemic index and glycemic load calculated per subject. S I and AIR were determined by frequently sampled intravenous glucose tolerance test. Disposition index was calculated by multiplying S I with AIR. Multiple linear regression modeling was employed.RESULTS -No association was observed between glycemic index and S I , fasting insulin, AIR, disposition index, BMI, or waist circumference after adjustment for demographic characteristics or family history of diabetes, energy expenditure, and smoking. Associations observed for digestible carbohydrates and glycemic load, respectively, with S I , insulin secretion, and adiposity (adjusted for demographics and main confounders) were entirely explained by energy intake. In contrast, fiber was associated positively with S I and disposition index and inversely with fasting insulin, BMI, and waist circumference but not with AIR.CONCLUSION -Carbohydrates as reflected in glycemic index and glycemic load may not be related to measures of insulin sensitivity, insulin secretion, and adiposity. Fiber intake may not only have beneficial effects on insulin sensitivity and adiposity, but also on pancreatic functionality.

show abstract

“…In the IRAS, dietary fat intake was positively related to insulin secretion, measured by the minimal model, in subjects with normal glucose tolerance but not in those with impaired glucose tolerance (28). In contrast, a study by Larsson et al (29) did not find any correlation between intake of specific dietary fatty acids and insulin secretory response to arginine in postmenopausal women.…”

Section: Methodsmentioning

confidence: 82%

Effects of Diets Enriched in Saturated (Palmitic), Monounsaturated (Oleic), or trans (Elaidic) Fatty Acids on Insulin Sensitivity and Substrate Oxidation in Healthy Adults

et al. 2002

View full text Add to dashboard Cite

OBJECTIVE -Diets high in total and saturated fat are associated with insulin resistance. This study examined the effects of feeding monounsaturated, saturated, and trans fatty acids on insulin action in healthy adults. RESEARCH DESIGN AND METHODS-A randomized, double-blind, crossover study was conducted comparing three controlled 4-week diets (57% carbohydrate, 28% fat, and 15% protein) enriched with different fatty acids in 25 healthy men and women. The monounsaturated fat diet (M) had 9% of energy as C18:1cis (oleic acid). The saturated fat diet (S) had 9% of energy as palmitic acid, and the trans fatty acid diet (T) had 9% as C18:1trans. Body weight was kept constant throughout the study. After each diet period, insulin pulsatile secretion, insulin sensitivity index (S I ) by the minimal model method, serum lipids, and fat oxidation by indirect calorimetry were measured.RESULTS -Mean S I for the M, S, and T diets was 3.44 Ϯ 0.26, 3.20 Ϯ 0.26, and 3.40 Ϯ 0.26 ϫ 10 Ϫ4 min Ϫ1 ⅐ U Ϫ1 ⅐ ml Ϫ1 , respectively (NS). S I decreased by 24% on the S versus M diet in overweight subjects but was unchanged in lean subjects (NS). Insulin secretion was unaffected by diet, whereas total and HDL cholesterol increased significantly on the S diet. Subjects oxidized the least fat on the M diet (26.0 Ϯ 1.5 g/day) and the most fat on the T diet (31.4 Ϯ 1.5 g/day) (P ϭ 0.02).CONCLUSIONS -Dietary fatty acid composition significantly influenced fat oxidation but did not impact insulin sensitivity or secretion in lean individuals. Overweight individuals were more susceptible to developing insulin resistance on high-saturated fat diets. Diabetes Care 25:1283-1288, 2002H igh-fat diets have been shown to produce insulin resistance relative to high-carbohydrate diets (1-4), and certain fatty acids may have a more deleterious effect on insulin action than others. In animal models, Storlien et al. (5,6) found that high intake of saturated and polyunsaturated fats induce severe insulin resistance, whereas monounsaturated fats and -3 fatty acids are less detrimental. In humans, saturated fatty acid intake is a significant independent predictor of fasting and postprandial insulin in middle-aged men (7) and young men and women (8).The composition of lipids in serum or muscle (markers of dietary fatty acid intake) also correlates with insulin resistance. In a cross-sectional population study of Ͼ4,000 healthy individuals, fasting insulin concentration was positively associated with the percentage of saturated fat and inversely associated with the percentage of monounsaturated fat in plasma phospholipids (9). We have previously reported inverse associations between insulin sensitivity and serum concentrations of myristic acid (C14:0), palmitoleic acid (C16:1), and dihomo-␥-linolenic acid (C20:3 n-6) (10). Similarly, an association between increased C16:1 and C20:3 n-6 in serum cholesterol esters and risk of developing type 2 diabetes has also been reported (11).Insulin secretion is also differentially effected by various fatty acids in vitro. Long...

show abstract

Insulin secretion, obesity, and potential behavioral influences: results from the Insulin Resistance Atherosclerosis Study (IRAS)

Abstract: Among non-diabetic patients, central obesity appears to be related to higher insulin secretion, but to lower capacity of the pancreas to respond to the ambient insulin resistance.

Cited by 28 publications

References 43 publications

Identification of Subjects with Insulin Resistance and β-Cell Dysfunction Using Alternative Definitions of the Metabolic Syndrome

Identification of Subjects with Insulin Resistance and β-Cell Dysfunction Using Alternative Definitions of the Metabolic Syndrome

Dietary Glycemic Index and Glycemic Load, Carbohydrate and Fiber Intake, and Measures of Insulin Sensitivity, Secretion, and Adiposity in the Insulin Resistance Atherosclerosis Study

Effects of Diets Enriched in Saturated (Palmitic), Monounsaturated (Oleic), or trans (Elaidic) Fatty Acids on Insulin Sensitivity and Substrate Oxidation in Healthy Adults

Contact Info

Product

Resources

About