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Effect of Aging on Glucose Homeostasis: Accelerated deterioration of β-cell function in individuals with impaired glucose tolerance
Ist Teil von
Diabetes care, 2008-03, Vol.31 (3), p.539-543
Ort / Verlag
Alexandria, VA: American Diabetes Association
Erscheinungsjahr
2008
Quelle
MEDLINE
Beschreibungen/Notizen
OBJECTIVE:--To examine the effect of aging on insulin secretion (first- and second-phase insulin release) and insulin sensitivity in people with normal glucose tolerance (NGT) or impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS--First- and second-phase insulin secretion and insulin sensitivity were assessed in hyperglycemic clamp experiments in 266 individuals with NGT and 130 individuals with IGT, ranging in age from ~20 to ~70 years. Changes in β-cell function were compared using the disposition index to adjust for differences in insulin sensitivity. RESULTS:--As expected, both phases of insulin release and insulin sensitivity were reduced in individuals with IGT (all P < 0.01). Insulin sensitivity was not independently correlated with age in either group. In people with NGT, the disposition index for first- and second-phase insulin release decreased similarly at a rate of ~0.7% per year. In people with IGT, the disposition indexes for first- and second-phase insulin release decreased at greater rates (~2.2 and 1.4% per year, P = 0.002 and 0.009, respectively, vs. NGT), with the decrease in first phase being greater than that of second phase (P = 0.025). CONCLUSIONS:--Insulin secretion (both first and second phase) normally decreases at a rate of ~0.7% per year with aging; this decrease in β-cell function is accelerated about two-fold in people with impaired glucose tolerance--first phase to a greater extent than second phase. Finally, aging per se has no effect on insulin sensitivity independent of changes in body composition.