Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp.

Rodent and cell‐culture models support a role for iron‐related adipokine dysregulation and insulin resistance in the pathogenesis of nonalcoholic fatty liver disease (NAFLD); however, substantial human data are lacking. We examined the relationship between measures of iron status, adipokines, and insulin resistance in patients with NAFLD in the presence and absence of venesection. This study forms part of the Impact of Iron on Insulin Resistance and Liver Histology in Nonalcoholic Steatohepatitis (IIRON2) study, a prospective randomized controlled trial of venesection for adults with NAFLD. Paired serum samples at baseline and 6 months (end of treatment) in controls (n = 28) and patients who had venesection (n = 23) were assayed for adiponectin, leptin, resistin, retinol binding protein‐4, tumor necrosis factor α, and interleukin‐6, using a Quantibody, customized, multiplexed enzyme‐linked immunosorbent assay array. Hepatic iron concentration (HIC) was determined using MR FerriScan. Unexpectedly, analysis revealed a significant positive correlation between baseline serum adiponectin concentration and HIC, which strengthened after correction for age, sex, and body mass index (rho = 0.36; P = 0.007). In addition, there were significant inverse correlations between HIC and measures of insulin resistance (adipose tissue insulin resistance (Adipo‐IR), serum insulin, serum glucose, homeostasis model assessment of insulin resistance, hemoglobin A1c, and hepatic steatosis), whereas a positive correlation was noted with the insulin sensitivity index. Changes in serum adipokines over 6 months did not differ between the control and venesection groups. Conclusion: HIC positively correlates with serum adiponectin and insulin sensitivity in patients with NAFLD. Further study is required to establish causality and mechanistic explanations for these associations and their relevance in the pathogenesis of insulin resistance and NAFLD. (Hepatology Communications 2018;2:644‐653)

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“…2B‐E). Furthermore, the insulin sensitivity index (ISI)26 was significantly positively correlated with HIC (Table 4; Fig. 2F).…”

Section: Resultsmentioning

confidence: 92%

Hepatic iron concentration correlates with insulin sensitivity in nonalcoholic fatty liver disease

Britton

Bridle

Reiling

et al. 2018

Hepatology Communications

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“…It was calculated as the change in plasma insulin (PI) from 0 to 30 minutes divided by the change in plasma glucose (PG) over the same period 32. The Matsuda ISI OGTT is an OGTT‐derived measure of whole‐body insulin sensitivity that has been validated against the euglycaemic insulin clamp technique 33. It was calculated using the 75‐g OGTT PG and PI concentrations as follows: √ (fasting PG × fasting PI × mean PG × mean PI), where PG was expressed in mg/dL (1/18 mmol/L) and PI in μU/mL (6 pmol/L).…”

Section: Methodsmentioning

confidence: 99%

The effect of small doses of fructose and allulose on postprandial glucose metabolism in type 2 diabetes: A double‐blind, randomized, controlled, acute feeding, equivalence trial

Noronha

Braunstein

Glenn

et al. 2018

Diabetes Obesity Metabolism

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AimTo assess and compare the effect of small doses of fructose and allulose on postprandial blood glucose regulation in type 2 diabetes.MethodsA double‐blind, multiple‐crossover, randomized, controlled, acute feeding, equivalence trial in 24 participants with type 2 diabetes was conducted. Each participant was randomly assigned six treatments separated by >1‐week washouts. Treatments consisted of fructose or allulose at 0 g (control), 5 g or 10 g added to a 75‐g glucose solution. A standard 75‐g oral glucose tolerance test protocol was followed with blood samples at −30, 0, 30, 60, 90 and 120 minutes. The primary outcome measure was plasma glucose incremental area under the curve (iAUC).ResultsAllulose significantly reduced plasma glucose iAUC by 8% at 10 g compared with 0 g (717.4 ± 38.3 vs. 777.5 ± 39.9 mmol × min/L, P = 0.015) with a linear dose response gradient between the reduction in plasma glucose iAUC and dose (P = 0.016). Allulose also significantly reduced several related secondary and exploratory outcome measures at 5 g (plasma glucose absolute mean and total AUC) and 10 g (plasma glucose absolute mean, absolute and incremental maximum concentration [Cmax], and total AUC) (P < .0125). There was no effect of fructose at any dose. Although allulose showed statistically significant reductions in plasma glucose iAUC compared with fructose at 5 g, 10 g and pooled doses, these reductions were within the pre‐specified equivalence margins of ±20%.ConclusionAllulose, but not fructose, led to modest reductions in the postprandial blood glucose response to oral glucose in individuals with type 2 diabetes. There is a need for long‐term randomized trials to confirm the sustainability of these improvements.

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“…The insulin sensitivity index (ISI) is based on post–glucose load measures. The ISI reflects whole‐body or peripheral insulin resistance, not only hepatic insulin resistance as reflected by the HOMA‐IR 13. A previous study showed that insulin resistance calculated by post–glucose load measures, but not by fasting insulin, was associated with a risk of incident ischemic stroke 7.…”

Section: Introductionmentioning

confidence: 99%

Post–Glucose Load Measures of Insulin Resistance and Prognosis of Nondiabetic Patients With Ischemic Stroke

Pan

Jing

Chen

et al. 2017

JAHA

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BackgroundInsulin resistance is associated with an increased risk of cardiovascular events in the general population. This study aimed to estimate the association between post–glucose load measures of insulin resistance and prognosis of nondiabetic patients with ischemic stroke.Methods and ResultsData were derived from the ACROSS‐China (Abnormal Glucose Regulation in Patients with Acute Stroke across China) registry. Patients with ischemic stroke without a history of diabetes mellitus were included. Two post–glucose load measures of insulin sensitivity, the insulin sensitivity indices ISI(composite) and the ISI 0,120, were calculated. Outcomes included stroke recurrence, all‐cause death, and poor functional outcome at 12 months. Among 1203 patients, 63.3% were male with an average age of 62.1 years. At 12 months, 168 (14.4%) patients had recurrent stroke, 111 (9.2%) had died, and 288 (24.4%) had poor outcome. After adjustment for potential covariates, the first quartile of the ISI(composite) was associated with increased 12‐month stroke recurrence (adjusted hazard ratio 2.02, 95% CI 1.28–3.18, P=0.003), death (adjusted hazard ratio 2.78, 95% CI 1.59–4.86, P<0.001), and poor outcome (adjusted odds ratio 2.67, 95% CI 1.69–4.21, P<0.001) compared with the fourth quartile. Similar results were observed for the ISI 0,120 but with a larger magnitude of association. Using a multivariable regression model with restricted cubic spline, we found an L‐shaped association between the insulin sensitivity indices and the risk of each end point.ConclusionsIn this large‐scale registry, post–glucose load measures of insulin resistance with the ISI(composite) and the ISI 0,120 were associated with 12‐month poor outcomes of nondiabetic patients with ischemic stroke.

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Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp.

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Hepatic iron concentration correlates with insulin sensitivity in nonalcoholic fatty liver disease

Hepatic iron concentration correlates with insulin sensitivity in nonalcoholic fatty liver disease

The effect of small doses of fructose and allulose on postprandial glucose metabolism in type 2 diabetes: A double‐blind, randomized, controlled, acute feeding, equivalence trial

Post–Glucose Load Measures of Insulin Resistance and Prognosis of Nondiabetic Patients With Ischemic Stroke

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