Early Insulin Response and Insulin Sensitivity are Equally Important as Predictors of Glucose Tolerance after Correction for Measurement Errors

Berglund, Lars,1955-Uppsala universitet,Geriatrik,Uppsala kliniska forskningscentrum (UCR) (författare)

Aims: We estimated measurement error (ME) corrected effects of insulin sensitivity (M/I), from euglycaemic insulin clamp, and insulin secretion, measured as early insulin response (EIR) from oral glucose tolerance test (OGTT), on fasting plasma glucose, HbA1c and type 2 diabetes longitudinally and cross-sectional. Methods: : In a population-based study (n = 1128 men) 17 men made replicate measurements to estimate ME at age 71 years. Effect of 1 SD decrease of predictors M/I and EIR on longitudinal response variables fasting plasma glucose (FPG) and HbA1c at follow-ups up to 11 years, were estimated using uncorrected and ME-corrected (with the regression calibration method) regression models. Results: : Uncorrected effect on FPG at age 77 years was larger for M/I than for EIR (effect difference 0.10 mmol/l, 95% CI 0.00;0.21), while ME-corrected effects were similar (0.02 mmol/l, 95% CI -0.13;0.15 mmol/l). EIR had greater ME-corrected impact than M/I on HbA1c at age 82 years (-0.11%, -0.28; -0.01%). Conclusions: : Due to higher ME effect of EIR on glycaemia is underestimated as compared with M/I. By correcting for ME valid estimates of relative contributions of insulin secretion and insulin sensitivity on glycaemia are obtained.

Berne, ChristianUppsala universitet,Institutionen för medicinska vetenskaper,Endokrin diabetes och metabolism(Swepub:uu)chber255 (författare)
Svärdsudd, KurtUppsala universitet,Allmänmedicin och klinisk epidemiologi(Swepub:uu)kurtsvar (författare)
Garmo, HansUppsala universitet,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)hga27600 (författare)
Zethelius, BjörnUppsala universitet,Geriatrik(Swepub:uu)bjorzeth (författare)
Uppsala universitetGeriatrik (creator_code:org_t)

Ingår i:Diabetes Research and Clinical Practice: Elsevier BV86:3, s. 219-2240168-82271872-8227

Av författaren/redakt...: Berglund, Lars, ...; Berne, Christian; Svärdsudd, Kurt; Garmo, Hans; Zethelius, Björn

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