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Mechanisms of hyperinsulinaemia in apparently healthy non-obese young adults: role of insulin secretion, clearance and action and associations with plasma amino acids

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posted on 2019-12-01, 00:00 authored by S Hamley, D Kloosterman, T Duthie, C Dalla Man, R Visentin, Shaun MasonShaun Mason, T Ang, Ahrathy SelathuraiAhrathy Selathurai, Gunveen KaurGunveen Kaur, M G Morales-Scholz, Kirsten HowlettKirsten Howlett, Greg KowalskiGreg Kowalski, Chris ShawChris Shaw, Clinton BruceClinton Bruce
Aims/hypothesis: This study aimed to examine the metabolic health of young apparently healthy non-obese adults to better understand mechanisms of hyperinsulinaemia. Methods: Non-obese (BMI < 30 kg/m2) adults aged 18–35 years (N = 254) underwent a stable isotope-labelled OGTT. Insulin sensitivity, glucose effectiveness and beta cell function were determined using oral minimal models. Individuals were stratified into quartiles based on their insulin response during the OGTT, with quartile 1 having the lowest and quartile 4 the highest responses. Results: Thirteen per cent of individuals had impaired fasting glucose (IFG; n = 14) or impaired glucose tolerance (IGT; n = 19), allowing comparisons across the continuum of insulin responses within the spectrum of normoglycaemia and prediabetes. BMI (~24 kg/m2) was similar across insulin quartiles and in those with IFG and IGT. Despite similar glycaemic excursions, fasting insulin, triacylglycerols and cholesterol were elevated in quartile 4. Insulin sensitivity was lowest in quartile 4, and accompanied by increased insulin secretion and reduced insulin clearance. Individuals with IFG had similar insulin sensitivity and beta cell function to those in quartiles 2 and 3, but were more insulin sensitive than individuals in quartile 4. While individuals with IGT had a similar degree of insulin resistance to quartile 4, they exhibited a more severe defect in beta cell function. Plasma branched-chain amino acids were not elevated in quartile 4, IFG or IGT. Conclusions/interpretation: Hyperinsulinaemia within normoglycaemic young, non-obese adults manifests due to increased insulin secretion and reduced insulin clearance. Individual phenotypic characterisation revealed that the most hyperinsulinaemic were more similar to individuals with IGT than IFG, suggesting that hyperinsulinaemic individuals may be on the continuum toward IGT. Furthermore, plasma branched-chain amino acids may not be an effective biomarker in identifying hyperinsulinaemia and insulin resistance in young non-obese adults.

History

Journal

Diabetologia

Volume

62

Issue

12

Pagination

2310 - 2324

Publisher

Springer

Location

Berlin, Germany

ISSN

0012-186X

eISSN

1432-0428

Language

eng

Publication classification

C1 Refereed article in a scholarly journal