Decreased non-insulin-dependent glucose clearance contributes to the rise in fasting plasma glucose in the nondiabetic range

Rucha Jani, Marjorie Molina, Masafumi Matsuda, Bogdan Balas, Alberto Chavez, Ralph A Defronzo, Muhammad A Abdul-ghani

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

OBJECTIVE - To assess the contribution of decreased glucose clearance to the rise in fasting plasma glucose (FPG) in the nondiabetic range. RESEARCH DESIGN AND METHODS - A total of 120 subjects with normal glucose tolerance received an oral glucose tolerance test and euglycemic insulin clamp with 3-[3H]glucose. The basal and insulin-stimulated rates of glucose appearance, glucose disappearance, and glucose clearance and the basal hepatic insulin resistance index were calculated. Simple Pearson's correlation was used to assess the relationship between variables. RESULTS - The increase in FPG (range 75-125 mg/dl) correlated (r = 0.32, P < 0.0001) with the increase in BMI (20-50 kg/m2). The fasting plasma insulin (FPI) concentration also increased progressively with the increase in BMI (r = 0.62, P < 0.0001). However, despite increasing FPI, the basal glucose clearance rate declined and correlated with the increase in BMI (r = -0.56, P < 0.0001). Basal hepatic glucose production (HGP) decreased with increasing BMI (r = -0.51, P < 0.0001) and correlated inversely with the increase in FPI (r = -0.32, P < 0.0001). The hepatic insulin resistance (basal HGP x FPI) increased with rising BMI (r = 0.52, P < 0.0001). During the insulin clamp, glucose disposal declined with increasing BMI (r = -0.64, P < 0.0001) and correlated with the basal glucose clearance (r = 0.39, P < 0.0001). CONCLUSIONS - These results demonstrate that in nondiabetic subjects, rising FPG is associated with a decrease (not an increase) in basal hepatic glucose production and is explained by a reduction in glucose clearance.

Original languageEnglish (US)
Pages (from-to)311-315
Number of pages5
JournalDiabetes Care
Volume31
Issue number2
DOIs
StatePublished - Feb 2008

Fingerprint

Fasting
Glucose
Insulin
Liver
Insulin Resistance
Glucose Clamp Technique
Glucose Tolerance Test
Research Design

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Decreased non-insulin-dependent glucose clearance contributes to the rise in fasting plasma glucose in the nondiabetic range. / Jani, Rucha; Molina, Marjorie; Matsuda, Masafumi; Balas, Bogdan; Chavez, Alberto; Defronzo, Ralph A; Abdul-ghani, Muhammad A.

In: Diabetes Care, Vol. 31, No. 2, 02.2008, p. 311-315.

Research output: Contribution to journalArticle

Jani, Rucha ; Molina, Marjorie ; Matsuda, Masafumi ; Balas, Bogdan ; Chavez, Alberto ; Defronzo, Ralph A ; Abdul-ghani, Muhammad A. / Decreased non-insulin-dependent glucose clearance contributes to the rise in fasting plasma glucose in the nondiabetic range. In: Diabetes Care. 2008 ; Vol. 31, No. 2. pp. 311-315.
@article{0585877f91984426af8f0ab734e2aa7d,
title = "Decreased non-insulin-dependent glucose clearance contributes to the rise in fasting plasma glucose in the nondiabetic range",
abstract = "OBJECTIVE - To assess the contribution of decreased glucose clearance to the rise in fasting plasma glucose (FPG) in the nondiabetic range. RESEARCH DESIGN AND METHODS - A total of 120 subjects with normal glucose tolerance received an oral glucose tolerance test and euglycemic insulin clamp with 3-[3H]glucose. The basal and insulin-stimulated rates of glucose appearance, glucose disappearance, and glucose clearance and the basal hepatic insulin resistance index were calculated. Simple Pearson's correlation was used to assess the relationship between variables. RESULTS - The increase in FPG (range 75-125 mg/dl) correlated (r = 0.32, P < 0.0001) with the increase in BMI (20-50 kg/m2). The fasting plasma insulin (FPI) concentration also increased progressively with the increase in BMI (r = 0.62, P < 0.0001). However, despite increasing FPI, the basal glucose clearance rate declined and correlated with the increase in BMI (r = -0.56, P < 0.0001). Basal hepatic glucose production (HGP) decreased with increasing BMI (r = -0.51, P < 0.0001) and correlated inversely with the increase in FPI (r = -0.32, P < 0.0001). The hepatic insulin resistance (basal HGP x FPI) increased with rising BMI (r = 0.52, P < 0.0001). During the insulin clamp, glucose disposal declined with increasing BMI (r = -0.64, P < 0.0001) and correlated with the basal glucose clearance (r = 0.39, P < 0.0001). CONCLUSIONS - These results demonstrate that in nondiabetic subjects, rising FPG is associated with a decrease (not an increase) in basal hepatic glucose production and is explained by a reduction in glucose clearance.",
author = "Rucha Jani and Marjorie Molina and Masafumi Matsuda and Bogdan Balas and Alberto Chavez and Defronzo, {Ralph A} and Abdul-ghani, {Muhammad A}",
year = "2008",
month = "2",
doi = "10.2337/dc07-1593",
language = "English (US)",
volume = "31",
pages = "311--315",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "2",

}

TY - JOUR

T1 - Decreased non-insulin-dependent glucose clearance contributes to the rise in fasting plasma glucose in the nondiabetic range

AU - Jani, Rucha

AU - Molina, Marjorie

AU - Matsuda, Masafumi

AU - Balas, Bogdan

AU - Chavez, Alberto

AU - Defronzo, Ralph A

AU - Abdul-ghani, Muhammad A

PY - 2008/2

Y1 - 2008/2

N2 - OBJECTIVE - To assess the contribution of decreased glucose clearance to the rise in fasting plasma glucose (FPG) in the nondiabetic range. RESEARCH DESIGN AND METHODS - A total of 120 subjects with normal glucose tolerance received an oral glucose tolerance test and euglycemic insulin clamp with 3-[3H]glucose. The basal and insulin-stimulated rates of glucose appearance, glucose disappearance, and glucose clearance and the basal hepatic insulin resistance index were calculated. Simple Pearson's correlation was used to assess the relationship between variables. RESULTS - The increase in FPG (range 75-125 mg/dl) correlated (r = 0.32, P < 0.0001) with the increase in BMI (20-50 kg/m2). The fasting plasma insulin (FPI) concentration also increased progressively with the increase in BMI (r = 0.62, P < 0.0001). However, despite increasing FPI, the basal glucose clearance rate declined and correlated with the increase in BMI (r = -0.56, P < 0.0001). Basal hepatic glucose production (HGP) decreased with increasing BMI (r = -0.51, P < 0.0001) and correlated inversely with the increase in FPI (r = -0.32, P < 0.0001). The hepatic insulin resistance (basal HGP x FPI) increased with rising BMI (r = 0.52, P < 0.0001). During the insulin clamp, glucose disposal declined with increasing BMI (r = -0.64, P < 0.0001) and correlated with the basal glucose clearance (r = 0.39, P < 0.0001). CONCLUSIONS - These results demonstrate that in nondiabetic subjects, rising FPG is associated with a decrease (not an increase) in basal hepatic glucose production and is explained by a reduction in glucose clearance.

AB - OBJECTIVE - To assess the contribution of decreased glucose clearance to the rise in fasting plasma glucose (FPG) in the nondiabetic range. RESEARCH DESIGN AND METHODS - A total of 120 subjects with normal glucose tolerance received an oral glucose tolerance test and euglycemic insulin clamp with 3-[3H]glucose. The basal and insulin-stimulated rates of glucose appearance, glucose disappearance, and glucose clearance and the basal hepatic insulin resistance index were calculated. Simple Pearson's correlation was used to assess the relationship between variables. RESULTS - The increase in FPG (range 75-125 mg/dl) correlated (r = 0.32, P < 0.0001) with the increase in BMI (20-50 kg/m2). The fasting plasma insulin (FPI) concentration also increased progressively with the increase in BMI (r = 0.62, P < 0.0001). However, despite increasing FPI, the basal glucose clearance rate declined and correlated with the increase in BMI (r = -0.56, P < 0.0001). Basal hepatic glucose production (HGP) decreased with increasing BMI (r = -0.51, P < 0.0001) and correlated inversely with the increase in FPI (r = -0.32, P < 0.0001). The hepatic insulin resistance (basal HGP x FPI) increased with rising BMI (r = 0.52, P < 0.0001). During the insulin clamp, glucose disposal declined with increasing BMI (r = -0.64, P < 0.0001) and correlated with the basal glucose clearance (r = 0.39, P < 0.0001). CONCLUSIONS - These results demonstrate that in nondiabetic subjects, rising FPG is associated with a decrease (not an increase) in basal hepatic glucose production and is explained by a reduction in glucose clearance.

UR - http://www.scopus.com/inward/record.url?scp=38949187199&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38949187199&partnerID=8YFLogxK

U2 - 10.2337/dc07-1593

DO - 10.2337/dc07-1593

M3 - Article

VL - 31

SP - 311

EP - 315

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 2

ER -