Metabolically healthy obese (MHO) are relatively insulin sensitive and have a favorable cardio-metabolic risk profile compared with metabolically abnormal obese (MAO). To evaluate whether MAO individuals have a decreased insulin clearance compared with MHO individuals, 49 MHO, 147 MAO, and 172 non-obese individuals were analyzed in this cross-sectional study. Insulin clearance and insulin sensitivity were assessed through euglycemic hyperinsulinemic clamp. MHO subjects exhibited significant lower triglycerides, total cholesterol, 2-h post-challenge glucose, fasting and 2-h post-challenge insulin, steady-state plasma insulin, alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyltransferase as compared with MAO individuals. Disposition index was higher in MHO subjects as compared with MAO individuals after adjusting for gender and age (P = 0.04). Insulin clearance was significantly lower in MAO individuals as compared with MHO and non-obese individuals. The difference between the two obese subgroups remained significant after adjusting for gender, age, waist circumference, fat mass, and insulin-stimulated glucose disposal (P = 0.03). The hepatic insulin extraction (C-peptide/insulin) in the fasting state was significantly higher in MHO subjects as compared with MAO individuals (P < 0.0001). In univariate analysis adjusted for gender and age, insulin clearance was correlated with hepatic insulin extraction (P = 0.01). In conclusion, insulin clearance differs among obese subjects with different metabolic phenotypes. Impaired insulin clearance may contribute to sustained fasting and post-meal hyperinsulinemia observed in MAO individuals.
Marini, M., Frontoni, S., Succurro, E., Arturi, F., Fiorentino, T., Sciacqua, A., et al. (2014). Differences in insulin clearance between metabolically healthy and unhealthy obese subjects. ACTA DIABETOLOGICA, 51(2), 257-261.
|Tipologia:||Articolo su rivista|
|Citazione:||Marini, M., Frontoni, S., Succurro, E., Arturi, F., Fiorentino, T., Sciacqua, A., et al. (2014). Differences in insulin clearance between metabolically healthy and unhealthy obese subjects. ACTA DIABETOLOGICA, 51(2), 257-261.|
|IF:||Con Impact Factor ISI|
|Settore Scientifico Disciplinare:||Settore MED/09 - Medicina Interna|
|Revisione (peer review):||Sì, ma tipo non specificato|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s00592-013-0511-9|
|Stato di pubblicazione:||Pubblicato|
|Data di pubblicazione:||apr-2014|
|Titolo:||Differences in insulin clearance between metabolically healthy and unhealthy obese subjects|
|Autori:||Marini, M; Frontoni, S; Succurro, E; Arturi, F; Fiorentino, T; Sciacqua, A; Perticone, F; Sesti, G|
|Appare nelle tipologie:||01 - Articolo su rivista|