Shape of the OGTT glucose curve and risk of impaired glucose metabolism in the EGIR-RISC cohort

Metabolism. 2017 May;70:42-50. doi: 10.1016/j.metabol.2017.02.007. Epub 2017 Feb 14.

Abstract

Objective: To study whether the shape of the oral glucose tolerance test (OGTT)-glucose curve is a stable trait over time; it is associated with differences in insulin sensitivity, ß-cell function and risk of impaired fasting glucose (IFG) and glucose tolerance (IGT) in the Relationship between Insulin Sensitivity and Cardiovascular Disease (RISC) cohort.

Methods: OGTT-glucose curve shape was classified as monophasic, biphasic, triphasic and anomalous in 915 individuals. Oral glucose insulin sensitivity (OGIS), Matsuda insulin sensitivity index (ISI) and ß-cell function were assessed at baseline and 3years apart.

Results: The OGTT-glucose curve had the same baseline shape after 3years in 540 people (59%; κ=0.115; p<0.0001). Seventy percent of the participants presented with monophasic OGTT-glucose curve shape at baseline and after 3years (percent positive agreement 0.74). Baseline monophasic shape was associated with significant increased risk of IFG (OR 1.514; 95% CI 1.084-2.116; p=0.015); biphasic shape with reduced risk of IGT (OR 0.539; 95% CI 0.310-0.936) and triphasic shape with reduced risk of IFG (OR 0.493; 95% CI 0.228-1.066; P=0.043) after 3years. Increased risks of IFG (OR 1.509; 95% CI 1.008-2.260; p=0.05) and IGT (OR 1.947; 95% CI 1.085-3.494; p=0.02) were found in people who kept stable monophasic morphology over time and in switchers from biphasic to monophasic shape (OR of IGT=3.085; 95% CI 1.377-6.912; p=0.001).

Conclusion: After 3years follow-up, the OGTT-glucose shape was stable in 59% of the RISC cohort. Shapes were associated with different OGIS and ß-cell function; persistence over time of the monophasic shape and switch from biphasic to monophasic shape with increased risk of impaired glucose metabolism.

Keywords: Glucose curve shape; Glucose tolerance; Insulin secretion; Insulin sensitivity; Oral glucose tolerance test.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Blood Glucose / metabolism
  • Cardiovascular Diseases / metabolism*
  • Cardiovascular System
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Glucose Intolerance / diagnosis
  • Glucose Intolerance / metabolism*
  • Glucose Tolerance Test*
  • Humans
  • Insulin Resistance
  • Insulin-Secreting Cells
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk

Substances

  • Blood Glucose