Oral Disposition Index in Obese Youth from Normal to Prediabetes to Diabetes: Relationship to Clamp Disposition Index - 23/06/12
Reprint requests: Silva Arslanian, MD, Children’s Hospital of Pittsburgh, 4401 Penn Avenue, Pittsburgh, PA 15224.Abstract |
Objective |
We sought to assess the glucose disposition index using an oral glucose tolerance test (OGTT; oDI) compared with the glucose disposition index measured from the combination of the euglycemic-hyperinsulinemic and hyperglycemic clamps (cDI) in obese pediatric subjects spanning the range of glucose tolerance.
Study design |
Overweight/obese adolescents (n = 185) with varying glucose tolerance (87 normal, 54 impaired, 31 with type 2 diabetes, and 13 with type 1 diabetes) completed an OGTT and both a hyperinsulinemic-euglycemic and a hyperglycemic clamp study. Indices of insulin sensitivity and β-cell function were calculated, and 4 different oDI estimates were calculated as the products of insulin and C-peptide-based sensitivity and secretion indices.
Results |
Mirroring the differences across groups by cDI, the oDI estimates were greatest in normal glucose tolerance adolescents and lowest in type 2 diabetes mellitus and obese with type 1 diabetes mellitus adolescents. The insulin-based oDI estimates correlated with cDI overall (r ≥ 0.74, P < .001) and within each glucose tolerance group (r ≥ 0.40, P < .001). Also, oDI and cDI predicted 2-hour OGTT glucose similarly.
Conclusions |
The oDI is a simple surrogate estimate of β-cell function relative to insulin sensitivity that can be applied to obese adolescents with varying glucose tolerance in large-scale epidemiological studies where the applicability of clamp studies is limited due to feasibility, cost, and labor intensiveness.
Le texte complet de cet article est disponible en PDF.Mots-clés : BMI, cDI, CF, DI, GAD65, GF, HbA1c, HOMA-IS, IA2, IF, IGT, ISSI-2, IVGTT, NGT, oDI, OGTT, OT1DM, PCOS, T2DM
Plan
| Supported by US Public Health Service grant R01 HD-27503 (to S.A.), K24 HD-01357 (to S.A.), Richard L. Day Endowed Chair (to S.A.), Department of Defense (to S.A., L.G., F.B., S.L. and H.T.), American Diabetes Association Junior Faculty Award (to S.L.), Thrasher Research Fund (to F.B.), and UL1 RR024153 CTSA (previously M01 RR-00084). The authors declare no conflicts of interest. |
Vol 161 - N° 1
P. 51-57 - juillet 2012 Retour au numéro
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