E. Rask et al., Impaired incretin response after a mixed meal is associated with insulin resistance in nondiabetic men, DIABET CARE, 24(9), 2001, pp. 1640-1645
OBJECTIVE - To investigate whether features of the insulin resistance syndr
ome are associated with altered incretin responses to food intake.
RESEARCH DESIGN AND METHODS- From a population-based study, 35 men were rec
ruited, representing a wide spectrum of insulin sensitivity and body weight
. Each subject underwent a hyperinsulinemic-euglycemic clamp to determine i
nsulin sensitivity. A mixed meal was given, and plasma levels of gastric in
hibitory polypeptide (GIP) and glucagon-like peptide 1 (GLP-1), as well as
insulin, glucagon, and glucose were measured.
RESULTS- insulin resistance was associated vith impaired GIP and GLP-1 resp
onses to a mixed meal. The total area under the curve (AUC) of the GIP resp
onse after the mixed meal was associated with insulin sensitivity (r = 0.54
. P < 0.01). There was a significant difference between the highest and the
lowest tertile of insulin sensitivity (P < 0.05). GLP-1 levels 15 min afte
r food intake were significantly lower in the most insulin-resistant tertil
e compared with the most insulin-sensitive tertile. During the first hour,
the AUC of GLP-1 correlated significantly with insulin sensitivity (r = 0.4
7, P < 0.01). Multiple linear regression analysis showed that insulin resis
tance, but not obesity, was an independent predictor of these decreased inc
retin responses.
CONCLUSIONS - in insulin resistance, the GIP and GLP-1 responses to a mixed
meal are impaired and are related to the degree of insulin resistance. Dec
reased incretin responsiveness may be of importance for the development of
impaired glucose tolerance.