The incretin effect in obese adolescents with and without type 2 diabetes: impaired or intact?
| Autor: | Benedikt A. Aulinger, Torsten P. Vahl, Ron L. Prigeon, Deborah A. Elder, David A. D'Alessio |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Blood Glucose
Male 0301 basic medicine endocrine system medicine.medical_specialty Adolescent endocrine system diseases Physiology Endocrinology Diabetes and Metabolism Incretin 030209 endocrinology & metabolism Type 2 diabetes Incretins Enteral administration Young Adult 03 medical and health sciences 0302 clinical medicine Physiology (medical) Internal medicine Insulin Secretion medicine Humans Insulin Secretion Obesity Insulin secretion business.industry nutritional and metabolic diseases Articles Glucose Tolerance Test medicine.disease Glucagon-like peptide-1 030104 developmental biology Endocrinology Diabetes Mellitus Type 2 Case-Control Studies Glucose-dependent insulinotropic polypeptide Female Insulin Resistance Prandial insulin business hormones hormone substitutes and hormone antagonists |
| Zdroj: | American Journal of Physiology-Endocrinology and Metabolism. 310:E774-E781 |
| ISSN: | 1522-1555 0193-1849 |
| Popis: | The incretin effect reflects the actions of enteral stimuli to promote prandial insulin secretion. Impairment of this measure has been proposed as an early marker of β-cell dysfunction and described in T2D, IGT, and even obesity without IGT. We sought to determine the effects of obesity and diabetes on the incretin effect in young subjects with short exposures to metabolic abnormalities and a few other confounding medical conditions. Subjects with T2D ( n = 10; 18.0 ± 0.4 yr) or NGT, either obese ( n = 11; 17.7 ± 0.4 yr) or lean ( n = 8; 26.5 ± 2.3 yr), had OGTT and iso-iv. The incretin effect was calculated as the difference in insulin secretion during these tests and was decreased ∼50% in both the NGT-Ob and T2D subjects relative to the NGT-Ln group. The T2D group had impaired glucose tolerance and insulin secretion during the OGTT, whereas the lean and obese NGT subjects had comparable glucose excursions and β-cell function. During the iso-iv test, the NGT-Ob subjects had significantly greater insulin secretion than the NGT-Ln and T2D groups. These findings demonstrate that in young subjects with early, well-controlled T2D the incretin effect is reduced, similar to what has been described in diabetic adults. The lower incretin effect calculated for the obese subjects with NGT is driven by a disproportionately greater insulin response to iv glucose and does not affect postprandial glucose regulation. These findings confirm that the incretin effect is an early marker of impaired insulin secretion in persons with abnormal glucose tolerance but suggest that in obese subjects with NGT the incretin effect calculation can be confounded by exaggerated insulin secretion to iv glucose. |
| Databáze: | OpenAIRE |
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