Glycaemic fall after a glucose load. A population-based study |
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Authors: | E. Casiglia V. Tikhonoff S. Caffi A. Bascelli F. Guglielmi A. Mazza B. Martini M. Saugo D. D'Este S. Masiero F. Guidotti G. Boschetti L. Schiavon P. Spinella S.V. de Kreutzenberg F. De Lazzari A.C. Pessina |
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Affiliation: | a Department of Clinical and Experimental Medicine, Chair of Internal Medicine, University of Padova, Via Giustiniani, 2, I-35128 Padova, Italy;b Department of Internal Medicine, Hospital of Venezia-Mestre, Mestre, Italy;c General Direction, Hospital of Verona, Verona, Italy;d Department of Internal Medicine, Hospital of Rovigo, Rovigo, Italy;e Department of Cardiology, Hospital of Thiene-Schio, Thiene, Italy;f Calculation Center, Local Health Unit No. 4, Regione Veneto, Thiene, Italy;g Department of Cardiology, Hospital of Mirano, Mirano, Italy;h Department of Clinical and Experimental Medicine, Chair of Clinical Nutrition, University of Padova, Padova, Italy;i Department of Clinical and Experimental Medicine, Chair of Diabetology, University of Padova, Padova, Italy |
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Abstract: | Background and aimsA blood glucose (BG) fall after an oral glucose load has never been described previously at a population level. This study was aimed at looking for a plasma glucose trend after an oral glucose load for possible blood glucose fall if any, and for its impact on coronary mortality at a population level.Methods and resultsIn subjects from an unselected general population, BG and insulin were detected before and 1 and 2 h after a 75-g oral glucose load for insulin sensitivity and β-cell function determination. Blood pressure, blood examinations and left ventricular mass were measured, and mortality was monitored for 18.8 ± 7.7 years. According to discriminant analysis, the population was stratified into cluster 0 (1-h BG < fasting BG; n = 497) and cluster 1 (1-h BG ≥ fasting BG; n = 1733). To avoid any interference of age and sex, statistical analysis was limited to two age–gender-matched cohorts of 490 subjects from each cluster (n = 940).Subjects in cluster 0 showed significantly higher insulin sensitivity and β-cell function, lower visceral adiposity and lower blood pressure values. Adjusted coronary mortality was 8 times lower in cluster 0 than 1 (p < 0.001). The relative risk of belonging to cluster 1 was 5.40 (95% CI 2.22–13.1).ConclusionIt seems that two clusters exist in the general population with respect to their response to an oral glucose load, independent of age and gender. Subjects who respond with a BG decrease could represent a privileged sub-population, where insulin sensitivity and β-cell function are better, some risk factors are less prevalent, and coronary mortality is lower. |
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Keywords: | Population Epidemiology Human Metabolic syndrome Oral glucose load Coronary Risk |
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