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Elevated 1-Hour Postload Plasma Glucose Levels Identify Subjects With Normal Glucose Tolerance but Impaired beta-Cell Function, Insulin Resistance, and Worse Cardiovascular Risk Profile The GENFIEV Study



Elevated 1-Hour Postload Plasma Glucose Levels Identify Subjects With Normal Glucose Tolerance but Impaired beta-Cell Function, Insulin Resistance, and Worse Cardiovascular Risk Profile The GENFIEV Study







In subjects with normal glucose tolerance (NGT) 1-hour postload plasma glucose (1-h oral glucose tolerance test [OG]) of >155 mg/dL predicts type 2 diabetes (T2DM) and is associated with subclinical atherosclerosis.The purpose of this study was to evaluate β-cell function, insulin resistance, and cardiovascular risk profile in subjects with NGT with a 1-h OG glucose of >155 mg/dL. and The GENFIEV (Genetics, PHYsiopathology, and Evolution of Type 2 diabetes) study is a multicenter study recruiting individuals at high risk of T2DM. A total of 926 subjects underwent a 75-g OG for assessment of plasma glucose and C-peptide for mathematical modeling of β-cell function (derivative and proportional control). Fasting insulin, lipid profile, and clinical parameters were determined as well. A 1-hour OG glucose of >155 mg/dL was found in 39% of subjects with NGT, 76% with impaired fasting glucose (IFG), 90% with impaired glucose tolerance (IGT), and 99% and 98% with IFG + IGT or newly diagnosed T2DM, respectively. Among subjects with NGT (n = 474), those with 1-hour OG glucose of >155 mg/dL were more insulin-resistant and had worse β-cell function than those with 1-hour OG glucose of ≤155 mg/dL. Moreover, glycosylated hemoglobin, blood pressure, low-density lipoprotein cholesterol, and triglycerides were higher in subjects with NGT with 1-hour OG glucose of >155 mg/dL, whereas high-density lipoprotein cholesterol was lower compared with that in subjects with NGT with 1-hour OG glucose of ≤155 mg/dL. Compared with subjects with IGT, those with NGT with 1-hour OG glucose of >155 mg/dL had comparable cardiovascular risk profile and insulin resistance but slightly better β-cell function. Among subjects with NGT, those with 1-hour OG glucose of >155 mg/dL showed lower insulin sensitivity, impaired β-cell function, and worse cardiovascular risk profile and therefore are at greater risk of developing T2DM and cardiovascular disease.

Accession: 036828284

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