Dataset Information

Serum ?-hydroxybutyrate (?-HB) predicts elevated 1?h glucose levels and early-phase ?-cell dysfunction during OGTT.

ABSTRACT:

Objective

Serum ?-hydroxybutyrate (?-HB) is elevated in insulin resistance and diabetes. We tested the hypothesis that the ?-HB level predicts abnormal 1?h glucose levels and ?-cell dysfunction inferred from plasma insulin kinetics during a 75?g oral glucose tolerance test (OGTT).

Research design and methods

This cross-sectional study included 217 patients at increased risk for diabetes. 75?g OGTTs were performed with multiple postload glucose and insulin measurements over a 30-120?min period. OGTT responses were analyzed by repeated measures analysis of variance (ANOVA). Multivariable logistic regression was used to predict 1?h glucose ?155?mg/dL with ?-HB added to traditional risk factors.

Results

Mean±SD age was 51±15?years (44% male, 25% with impaired glucose tolerance). Fasting glucose and insulin levels, but not age or body mass index (BMI), were significantly higher in the second/third ?-HB tertiles (>3.9?µg/mL) than in the first tertile. Patients in the second/third ?-HB tertiles exhibited a higher glucose area under the receiver operating characteristics curve (AUC) and reduced initial slope of insulin response during OGTT. The AUC for predicting 1?h glucose ?155?mg/dL was 0.82 for a base model that included age, gender, BMI, fasting glucose, glycated hemoglobin (HbA1c), and insulin, and increased to 0.86 with ?-HB added (p=0.015), with a net reclassification index of 52% (p<0.0001).

Conclusions

Fasting serum ?-HB levels predicted elevated 1?h glucose during OGTT, potentially due to impaired insulin secretion kinetics. This association persisted even in patients with an otherwise normal insulin-glucose homeostasis. Measuring serum ?-HB could thus provide a rapid, inexpensive screening tool for detecting early subclinical hyperglycemia, ?-cell dysfunction, and increased risk for diabetes.

SUBMITTER: Varvel SA

PROVIDER: S-EPMC4212560 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Serum α-hydroxybutyrate (α-HB) predicts elevated 1 h glucose levels and early-phase β-cell dysfunction during OGTT.

Varvel Stephen A SA Pottala James V JV Thiselton Dawn L DL Caffrey Rebecca R Dall Tara T Sasinowski Maciek M McConnell Joseph P JP Warnick G Russell GR Voros Szilard S Graham Timothy E TE

BMJ open diabetes research & care 20140924 1

<h4>Objective</h4>Serum α-hydroxybutyrate (α-HB) is elevated in insulin resistance and diabetes. We tested the hypothesis that the α-HB level predicts abnormal 1 h glucose levels and β-cell dysfunction inferred from plasma insulin kinetics during a 75 g oral glucose tolerance test (OGTT).<h4>Research design and methods</h4>This cross-sectional study included 217 patients at increased risk for diabetes. 75 g OGTTs were performed with multiple postload glucose and insulin measurements over a 30-12 ...[more]

PMID: 25452875

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