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

Shape of the OGTT glucose curve and risk of impaired glucose metabolism in the EGIR-RISC cohort.
Author Information (click to view)

Manco M, Nolfe G, Pataky Z, Monti L, Porcellati F, Gabriel R, Mitrakou A, Mingrone G,


Manco M, Nolfe G, Pataky Z, Monti L, Porcellati F, Gabriel R, Mitrakou A, Mingrone G, (click to view)

Manco M, Nolfe G, Pataky Z, Monti L, Porcellati F, Gabriel R, Mitrakou A, Mingrone G,

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Metabolism: clinical and experimental 2017 02 1470() 42-50 pii S0026-0495(17)30054-9
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.

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