Stephanie T Chung1, Mirella Galvan-De La Cruz1, Paola C Aldana1, Lilian S Mabundo1, Christopher W DuBose1, Anthony U Onuzuruike1, Mary Walter1, Ahmed M Gharib1, Amber B Courville2, Arthur S Sherman3, Anne E Sumner1,4. 1. Section on Ethnicity and Health, Diabetes, Endocrinology and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland. 2. National Institutes of Health Clinical Center, Bethesda, Maryland. 3. Laboratory of Biological Modeling, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland. 4. National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland.
Abstract
Context: Postprandial hyperinsulinemia might be an important cardiometabolic risk determinant in black compared with white women. However, the contributions of insulin clearance and β-cell function to racial differences in postprandial insulin response are unknown. Objective: To compare, by race and menopause, early insulin response to oral and intravenous glucose and to measure postprandial intact glucagon-like peptide 1 (GLP-1) concentrations, insulin clearance, and β-cell function. Design and Participants: 119 federally employed women without diabetes [87 premenopausal (52 black, 35 white) and 32 postmenopausal (19 black, 13 white)] underwent an oral glucose tolerance test, insulin-modified frequently sampled intravenous glucose test (IM-FSIGT), and mixed meal tolerance test (MMTT). Outcome Measures: Early insulin response was measured as follows: (i) insulinogenic index (oral glucose tolerance test); (ii) acute insulin response to glucose (IM-FSIGT); and (iii) ratio of incremental insulin/glucose area under the curve in the first 30 minutes of the MMTT. Insulin clearance was assessed during the IM-FSIGT and MMTT. During the MMTT, intact GLP-1 was measured and β-cell function assessed using the insulin secretion rate and β-cell responsivity indexes. Results: Black pre-menopausal and postmenopausal women had a greater insulin response and lower insulin clearance and greater dynamic β-cell responsivity (P ≤ 0.05 for all). No differences were found in the total insulin secretion rates or intact GLP-1 concentrations. Conclusions: Greater postprandial hyperinsulinemia in black pre-menopausal and postmenopausal women was associated with lower hepatic insulin clearance and heightened β-cell capacity to rapid changes in glucose, but not to higher insulin secretion. The relationship of increased β-cell secretory capacity, reduced insulin clearance, and ambient hyperinsulinemia to the development of cardiometabolic disease requires further investigation.
Context: Postprandial hyperinsulinemia might be an important cardiometabolic risk determinant in black compared with white women. However, the contributions of insulin clearance and β-cell function to racial differences in postprandial insulin response are unknown. Objective: To compare, by race and menopause, early insulin response to oral and intravenous glucose and to measure postprandial intact glucagon-like peptide 1 (GLP-1) concentrations, insulin clearance, and β-cell function. Design and Participants: 119 federally employed women without diabetes [87 premenopausal (52 black, 35 white) and 32 postmenopausal (19 black, 13 white)] underwent an oral glucose tolerance test, insulin-modified frequently sampled intravenous glucose test (IM-FSIGT), and mixed meal tolerance test (MMTT). Outcome Measures: Early insulin response was measured as follows: (i) insulinogenic index (oral glucose tolerance test); (ii) acute insulin response to glucose (IM-FSIGT); and (iii) ratio of incremental insulin/glucose area under the curve in the first 30 minutes of the MMTT. Insulin clearance was assessed during the IM-FSIGT and MMTT. During the MMTT, intact GLP-1 was measured and β-cell function assessed using the insulin secretion rate and β-cell responsivity indexes. Results: Black pre-menopausal and postmenopausal women had a greater insulin response and lower insulin clearance and greater dynamic β-cell responsivity (P ≤ 0.05 for all). No differences were found in the total insulin secretion rates or intact GLP-1 concentrations. Conclusions: Greater postprandial hyperinsulinemia in black pre-menopausal and postmenopausal women was associated with lower hepatic insulin clearance and heightened β-cell capacity to rapid changes in glucose, but not to higher insulin secretion. The relationship of increased β-cell secretory capacity, reduced insulin clearance, and ambient hyperinsulinemia to the development of cardiometabolic disease requires further investigation.
Authors: P Brandimarti; J M Costa-Júnior; S M Ferreira; A O Protzek; G J Santos; E M Carneiro; A C Boschero; L F Rezende Journal: J Endocrinol Date: 2013-10-04 Impact factor: 4.286
Authors: Ranganath Muniyappa; Vandana Sachdev; Stanislav Sidenko; Madia Ricks; Darleen C Castillo; Amber B Courville; Anne E Sumner Journal: Am J Physiol Endocrinol Metab Date: 2011-11-01 Impact factor: 4.310
Authors: S M Haffner; R D'Agostino; M F Saad; M Rewers; L Mykkänen; J Selby; G Howard; P J Savage; R F Hamman; L E Wagenknecht Journal: Diabetes Date: 1996-06 Impact factor: 9.461
Authors: Kara L Marlatt; Leanne M Redman; Robbie A Beyl; Steve R Smith; Catherine M Champagne; Fanchao Yi; Jennifer C Lovejoy Journal: Am J Obstet Gynecol Date: 2019-10-11 Impact factor: 8.661
Authors: Stephanie T Chung; Celeste K L Cravalho; Abby G Meyers; Amber B Courville; Shanna Yang; Nirupa Rachel Matthan; Lilian Mabundo; Maureen Sampson; Ronald Ouwerkerk; Ahmed M Gharib; Alice H Lichtenstein; Alan T Remaley; Anne E Sumner Journal: Circ Res Date: 2019-10-18 Impact factor: 17.367
Authors: Meera Ladwa; Oluwatoyosi Bello; Olah Hakim; Fariba Shojaee-Moradie; Maria Linda Boselli; Geoff Charles-Edwards; Janet Peacock; A Margot Umpleby; Stephanie A Amiel; Riccardo C Bonadonna; Louise M Goff Journal: BMJ Open Diabetes Res Care Date: 2021-03