A mixed meal tolerance test predicts onset of type 2 diabetes in Southwestern Indigenous adults.

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Nutrition & Diabetes Pub Date : 2024-07-10 DOI:10.1038/s41387-024-00269-3

Cassie M Mitchell, Emma J Stinson, Douglas C Chang, Jonathan Krakoff

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Abstract

Background/objective: To identify predictors of incident type 2 diabetes using a mixed meal tolerance test (MMTT).

Methods: Adult Indigenous Americans without diabetes (n = 501) from a longitudinal cohort underwent at baseline a 4-h MMTT, measures of body composition, an oral glucose tolerance test, an intravenous glucose tolerance test for acute insulin response (AIR), and a hyperinsulinemic-euglycemic clamp for insulin action (M). Plasma glucose responses from the MMTT were quantified by the total and incremental area under the curve (AUC/iAUC).

Results: At follow-up (median time 9.6 [inter-quartile range: 5.6-13.5] years), 169 participants were diagnosed with diabetes. Unadjusted Cox proportional hazards models, glucose AUC_180-min (HR: 1.98, 95% CI: 1.67, 2.34, p < 0.0001), AUC_240-min (HR: 1.93, 95% CI: 1.62, 2.31, p < 0.0001), and iAUC_180-min (HR: 1.43, 95% CI: 1.20, 1.71, p < 0.0001) were associated with an increased risk of diabetes. After adjustment for covariates (age, sex, body fat percentage, M, AIR, Indigenous American heritage) in three subsequent models, AUC_180-min (HR: 1.44, 95% CI: 1.10, 1.88, p = 0.007) and AUC_240-min (HR: 1.41, 95% CI: 1.09, 1.84, p < 0.01) remained associated with increased risk of diabetes.

Conclusions: Glucose responses to a mixed meal predicted the development of type 2 diabetes. This indicates that a mixed nutritional challenge provides important information on disease risk.

Clinical trial registry: ClinicalTrials.gov identifier : NCT00340132, NCT00339482.

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混合膳食耐量测试可预测西南部土著成人 2 型糖尿病的发病情况。

背景/目的利用混合膳食耐受试验（MMTT）确定2型糖尿病发病的预测因素：方法：来自纵向队列的未患糖尿病的成年美国原住民（n = 501）在基线时接受了 4 小时 MMTT、身体成分测量、口服葡萄糖耐量试验、急性胰岛素反应（AIR）静脉葡萄糖耐量试验和胰岛素作用（M）高胰岛素血糖钳夹。通过总曲线下面积和增量曲线下面积（AUC/iAUC）对 MMTT 的血浆葡萄糖反应进行量化：随访期间（中位数为 9.6 年[四分位数间距：5.6-13.5]），169 名参与者被确诊为糖尿病。未经调整的 Cox 比例危险模型显示，葡萄糖 AUC180-min （HR：1.98，95% CI：1.67，2.34，p 240-min（HR：1.93，95% CI：1.62，2.31，p 180-min（HR：1.43，95% CI：1.20，1.71，p 180-min（HR：1.44，95% CI：1.10，1.88，p = 0.007）和 AUC240-min（HR：1.41，95% CI：1.09，1.84，p 结论：对混合餐的血糖反应可预测 2 型糖尿病的发展。这表明，混合营养挑战提供了有关疾病风险的重要信息：临床试验登记：ClinicalTrials.gov 标识符：NCT00340132、NCT00339482。

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来源期刊

Nutrition & Diabetes ENDOCRINOLOGY & METABOLISM-NUTRITION & DIETETICS

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Nutrition & Diabetes is a peer-reviewed, online, open access journal bringing to the fore outstanding research in the areas of nutrition and chronic disease, including diabetes, from the molecular to the population level.