Reduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus

Abstract Hyperglycemia and insulin resistance contribute to vascular damage and are regulated by different pathophysiological processes. The aim of the study was to systematically investigate the relative contributions of multiple fasting state- and oral glucose tolerance test (oGTT)-derived glycemi...

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Autores principales:	Elko Randrianarisoa, Angela Lehn-Stefan, Anja Hieronimus, Robert Wagner, Jakob Maucher, Kilian Rittig, Bernd Balletshofer, Andreas L. Birkenfeld, Andreas Peter, Norbert Stefan, Hans-Ulrich Häring, Andreas Fritsche, Martin Heni
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/1ce8aabe4d1c43ca8b9afe0569084df2
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spelling	oai:doaj.org-article:1ce8aabe4d1c43ca8b9afe0569084df22021-12-02T14:01:28ZReduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus10.1038/s41598-020-80581-x2045-2322https://doaj.org/article/1ce8aabe4d1c43ca8b9afe0569084df22020-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-80581-xhttps://doaj.org/toc/2045-2322Abstract Hyperglycemia and insulin resistance contribute to vascular damage and are regulated by different pathophysiological processes. The aim of the study was to systematically investigate the relative contributions of multiple fasting state- and oral glucose tolerance test (oGTT)-derived glycemic traits to carotid intima-media thickness (cIMT), a surrogate parameter of subclinical atherosclerosis, in individuals with increased risk for type 2 diabetes mellitus (T2D). 667 volunteers (417 women and 250 men, mean age 44.1 years), who were free of cardiovascular disease (CVD), were included in this cross-sectional study. Glucose tolerance, insulin sensitivity, insulin secretion and insulin clearance were assessed by frequently sampled 75 g oGTT. CIMT was measured by high-resolution ultrasound. Insulin clearance was associated with cIMT in univariate analysis (ßst = − 0.17, p < 0.0001) and in a stepwise regression analysis on 15 variables possibly affecting cIMT, age (r2 = 0.3923, p < 0.0001), insulin clearance (r2 = 0.4564, p < 0.0001), systolic blood pressure (r2 = 0.4733, p < 0.0001), body mass index (BMI) (r2 = 0.4804, p = 0.002), gender (r2 = 0.4831, p = 0.013), and fasting insulin clearance (r2 = 0.4857, p = 0.030) turned out to be significant determinants of cIMT. In a cross-validated model resulting from this analysis, insulin clearance was found to be an independent determinant of cIMT (ßst = − 0.16, p < 0.0001) even after adjusting for traditional CVD risk factors. Reduced insulin clearance may be an early marker of damage on the vasculature, independent of classical CVD risk factors. Reduced insulin clearance should be considered with regard to vascular insulin resistance.Elko RandrianarisoaAngela Lehn-StefanAnja HieronimusRobert WagnerJakob MaucherKilian RittigBernd BalletshoferAndreas L. BirkenfeldAndreas PeterNorbert StefanHans-Ulrich HäringAndreas FritscheMartin HeniNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-8 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Elko Randrianarisoa Angela Lehn-Stefan Anja Hieronimus Robert Wagner Jakob Maucher Kilian Rittig Bernd Balletshofer Andreas L. Birkenfeld Andreas Peter Norbert Stefan Hans-Ulrich Häring Andreas Fritsche Martin Heni Reduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus
description	Abstract Hyperglycemia and insulin resistance contribute to vascular damage and are regulated by different pathophysiological processes. The aim of the study was to systematically investigate the relative contributions of multiple fasting state- and oral glucose tolerance test (oGTT)-derived glycemic traits to carotid intima-media thickness (cIMT), a surrogate parameter of subclinical atherosclerosis, in individuals with increased risk for type 2 diabetes mellitus (T2D). 667 volunteers (417 women and 250 men, mean age 44.1 years), who were free of cardiovascular disease (CVD), were included in this cross-sectional study. Glucose tolerance, insulin sensitivity, insulin secretion and insulin clearance were assessed by frequently sampled 75 g oGTT. CIMT was measured by high-resolution ultrasound. Insulin clearance was associated with cIMT in univariate analysis (ßst = − 0.17, p < 0.0001) and in a stepwise regression analysis on 15 variables possibly affecting cIMT, age (r2 = 0.3923, p < 0.0001), insulin clearance (r2 = 0.4564, p < 0.0001), systolic blood pressure (r2 = 0.4733, p < 0.0001), body mass index (BMI) (r2 = 0.4804, p = 0.002), gender (r2 = 0.4831, p = 0.013), and fasting insulin clearance (r2 = 0.4857, p = 0.030) turned out to be significant determinants of cIMT. In a cross-validated model resulting from this analysis, insulin clearance was found to be an independent determinant of cIMT (ßst = − 0.16, p < 0.0001) even after adjusting for traditional CVD risk factors. Reduced insulin clearance may be an early marker of damage on the vasculature, independent of classical CVD risk factors. Reduced insulin clearance should be considered with regard to vascular insulin resistance.
format	article
author	Elko Randrianarisoa Angela Lehn-Stefan Anja Hieronimus Robert Wagner Jakob Maucher Kilian Rittig Bernd Balletshofer Andreas L. Birkenfeld Andreas Peter Norbert Stefan Hans-Ulrich Häring Andreas Fritsche Martin Heni
author_facet	Elko Randrianarisoa Angela Lehn-Stefan Anja Hieronimus Robert Wagner Jakob Maucher Kilian Rittig Bernd Balletshofer Andreas L. Birkenfeld Andreas Peter Norbert Stefan Hans-Ulrich Häring Andreas Fritsche Martin Heni
author_sort	Elko Randrianarisoa
title	Reduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus
title_short	Reduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus
title_full	Reduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus
title_fullStr	Reduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus
title_full_unstemmed	Reduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus
title_sort	reduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/1ce8aabe4d1c43ca8b9afe0569084df2
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Reduced insulin clearance is linked to subclinical atherosclerosis in individuals at risk for type 2 diabetes mellitus

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