PMID- 38115089 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20231222 IS - 1758-5996 (Print) IS - 1758-5996 (Electronic) IS - 1758-5996 (Linking) VI - 15 IP - 1 DP - 2023 Dec 20 TI - Fasting hepatic insulin clearance reflects postprandial hepatic insulin clearance: a brief report. PG - 261 LID - 10.1186/s13098-023-01241-4 [doi] LID - 261 AB - BACKGROUND: Hepatic insulin clearance (HIC) is an important pathophysiology of type 2 diabetes mellitus (T2DM). HIC was reported to decrease in patients with type 2 diabetes and metabolic syndrome. HIC is originally calculated by post-load insulin and C-peptide from the oral glucose tolerance test (OGTT). However, OGTT or meal tolerance tests are a burden for patients, and OGTT is not suitable for overt diabetes due to the risk of hyperglycemia. If we can calculate the HIC from the fasting state, it is preferable. We hypothesized that fasting HIC correlates with postprandial HIC in both participants with T2DM and without diabetes. We investigated whether fasting HIC correlates with postprandial HIC in overt T2DM and nondiabetes subjects (non-DM) evaluated by using glucose clamp and meal load. METHODS: We performed a meal tolerance test and hyperinsulinemic-euglycemic clamp in 70 subjects, 31 patients with T2DM and 39 non-DM subjects. We calculated the postprandial C-peptide AUC-to-insulin AUC ratio as the postprandial HIC and the fasting C-peptide-to-insulin ratio as the fasting HIC. We also calculated whole-body insulin clearance from the glucose clamp test. RESULTS: The fasting HIC significantly correlated with postprandial HIC in T2DM (r_S = 0.82, P < 0.001). Nondiabetes subjects also showed a significant correlation between fasting and postprandial HIC (r_S = 0.71, P < 0.001). Fasting HIC in T2DM was correlated with BMI, HbA1c, gamma-glutamyl transpeptidase, HOMA-IR, HOMA-beta, M/I, and whole-body insulin clearance. Fasting HIC in nondiabetes subjects was correlated with HOMA-IR and HOMA-beta. CONCLUSIONS: These results suggest that fasting HIC is strongly correlated with postprandial HIC in both overt T2DM and non-DM patients, as evaluated by the meal test and glucose clamp method. Fasting HIC could be a convenient marker of HIC. CI - (c) 2023. The Author(s). FAU - Okura, Tsuyoshi AU - Okura T AUID- ORCID: 0000-0003-3713-6617 AD - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. ohkura@tottori-u.ac.jp. FAU - Nakamura, Risa AU - Nakamura R AD - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. FAU - Kitao, Sonoko AU - Kitao S AD - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. FAU - Ito, Yuichi AU - Ito Y AD - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. FAU - Anno, Mari AU - Anno M AD - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. FAU - Matsumoto, Kazuhisa AU - Matsumoto K AD - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. FAU - Shoji, Kyoko AU - Shoji K AD - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. FAU - Matsuzawa, Kazuhiko AU - Matsuzawa K AD - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. FAU - Izawa, Shoichiro AU - Izawa S AD - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. FAU - Okura, Hiroko AU - Okura H AD - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. FAU - Ueta, Etsuko AU - Ueta E AD - School of Health Science, Tottori University Faculty of Medicine, Yonago, Tottori, Japan. FAU - Kato, Masahiko AU - Kato M AD - School of Health Science, Tottori University Faculty of Medicine, Yonago, Tottori, Japan. FAU - Imamura, Takeshi AU - Imamura T AD - Division of Molecular Pharmacology, Tottori University Faculty of Medicine, Yonago, Tottori, Japan. FAU - Taniguchi, Shin-Ichi AU - Taniguchi SI AD - Department of Community-based Family Medicine, Tottori University Faculty of Medicine, Yonago, Tottori, Japan. FAU - Yamamoto, Kazuhiro AU - Yamamoto K AD - Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan. LA - eng GR - 22K07443/Japan Society for the Promotion of Science/ PT - Journal Article DEP - 20231220 PL - England TA - Diabetol Metab Syndr JT - Diabetology & metabolic syndrome JID - 101488958 PMC - PMC10731793 OTO - NOTNLM OT - Clearance and action OT - Insulin OT - Insulin clamp OT - Type 2 diabetes COIS- The authors declare no competing interests. EDAT- 2023/12/20 06:42 MHDA- 2023/12/20 06:43 PMCR- 2023/12/20 CRDT- 2023/12/20 00:22 PHST- 2023/10/08 00:00 [received] PHST- 2023/12/12 00:00 [accepted] PHST- 2023/12/20 06:43 [medline] PHST- 2023/12/20 06:42 [pubmed] PHST- 2023/12/20 00:22 [entrez] PHST- 2023/12/20 00:00 [pmc-release] AID - 10.1186/s13098-023-01241-4 [pii] AID - 1241 [pii] AID - 10.1186/s13098-023-01241-4 [doi] PST - epublish SO - Diabetol Metab Syndr. 2023 Dec 20;15(1):261. doi: 10.1186/s13098-023-01241-4.