Details

Autor(en) / Beteiligte

• Chung, Stephanie T
• Galvan-De La Cruz, Mirella
• Aldana, Paola C
• Mabundo, Lilian S
• DuBose, Christopher W
• Onuzuruike, Anthony U
• Walter, Mary
• Gharib, Ahmed M
• Courville, Amber B
• Sherman, Arthur S
• Sumner, Anne E

Titel

Postprandial Insulin Response and Clearance Among Black and White Women: The Federal Women’s Study

Ist Teil von

• The journal of clinical endocrinology and metabolism, 2019-01, Vol.104 (1), p.181-192

Ort / Verlag

Washington, DC: Endocrine Society

Erscheinungsjahr

2019

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• 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. A greater postprandial insulin response, relative to glucose, in black compared with white women was associated with lower insulin clearance but not increased insulin secretion.