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Authors
Okura, Tsuyoshi Division of Endocrinology and Metabolism, Tottori University Researchers DB KAKEN
Fujioka, Yohei Division of Endocrinology and Metabolism, Tottori University Researchers DB KAKEN
Nakamura, Risa Division of Endocrinology and Metabolism, Tottori University
Anno, Mari Division of Endocrinology and Metabolism, Tottori University
Ito, Yuichi Division of Endocrinology and Metabolism, Tottori University
Kitao, Sonoko Division of Endocrinology and Metabolism, Tottori University
Matsumoto, Kazuhisa Division of Endocrinology and Metabolism, Tottori University
Shoji, Kyoko Division of Endocrinology and Metabolism, Tottori University
Sumi, Keisuke Division of Endocrinology and Metabolism, Tottori University
Matsuzawa, Kazuhiko Division of Endocrinology and Metabolism, Tottori University Researchers DB
Izawa, Shoichiro Division of Endocrinology and Metabolism, Tottori University Researchers DB KAKEN
Okura, Hiroko Division of Endocrinology and Metabolism, Tottori University
Ueta, Etsuko School of Health Science, Tottori University
Noma, Hisashi Institute of Statistical Mathematics
Kato, Masahiko School of Health Science Major in Clinical LaboratoryScience, Tottori University Researchers DB KAKEN
Imamura, Takeshi Division of Molecular Pharmacology, Tottori University Researchers DB KAKEN
Taniguchi, Shin-ichi Department of Regional Medicine, Tottori University Researchers DB KAKEN
Yamamoto, Kazuhiro Division of Endocrinology and Metabolism, Tottori University Researchers DB KAKEN
Keywords
insulin
clearance and action
type 2 diabetes
insulin clamp
Abstract
Introduction: Hepatic insulin clearance (HIC) is an important pathophysiology of type 2 diabetes. HIC was reported to decrease in patients with type 2 diabetes and metabolic syndrome. However, hyperglycemia was suggested to enhance HIC, and it is not known whether poorly controlled diabetes increases HIC in patients with type 2 diabetes. We investigated whether HIC was increased in patients with poorly controlled diabetes, and whether HIC was associated with insulin resistance and incretins. Research: design and methods We performed a meal tolerance test and the hyperinsulinemic–euglycemic clamp in 21 patients with type 2 diabetes. We calculated the postprandial C-peptide area under the curve (AUC)-to-insulin AUC ratio as the HIC; measured fasting and postprandial glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and glucagon levels and analyzed serum adiponectin and zinc transporter-8 (ZnT8) gene polymorphism. Results: The HIC significantly correlated with glycated hemoglobin (HbA1c) (r_S=0.58, p<0.01). In patients with high HIC above the median of 6.5, the mean HbA1c was significantly higher compared with low HIC below the median. Homeostatic model assessment (HOMA)-beta (r_S=−0.77, p<0.01) and HOMA-IR (r_S=−0.66, p<0.005) were correlated with HIC. The M/I value in the clamp study was correlated with HIC. GLP-1-AUC and GIP-AUC were not correlated with HIC. Glucagon-AUC was negatively correlated with HIC, but there were no significant differences between the high and low HIC groups. Adiponectin was positively correlated with HIC. The ZnT8 gene polymorphism did not affect HIC. Conclusions: These results suggest that HIC was increased in patients with high HbA1c type 2 diabetes, low insulin secretion, low insulin resistance and high adiponectin conditions.
Publisher
BMJ
Content Type
Journal Article
Link
EISSN
20524897
Journal Title
BMJ OPEN DIABETES RESEARCH & CARE
Current Journal Title
BMJ OPEN DIABETES RESEARCH & CARE
Volume
8
Issue
1
Published Date
2020-01
Publisher-DOI
Text Version
Publisher
Rights
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Citation
Okura Tsuyoshi, Fujioka Yohei, Nakamura Risa, et al. Hepatic insulin clearance is increased in patients with high HbA1c type 2 diabetes: a preliminary report. BMJ OPEN DIABETES RESEARCH & CARE. 2020. 8(1). doi:10.1136/bmjdrc-2019-001149
Department
Faculty of Medicine/Graduate School of Medical Sciences/University Hospital
Language
English
Web of Science Key ut
WOS:000534740200060