Faculty of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada.
Institut de Recherches Cliniques de Montréal (IRCM), Montréal, QC H2W 1R7, Canada.
Int J Mol Sci. 2023 Mar 24;24(7):6130. doi: 10.3390/ijms24076130.
Sex-specific differences exist in insulin secretion (ISec) and sensitivity (IS) in humans. However, current fasting indices used to estimate them, such as HOMA and QUICKI, are not sex-specific. We aimed to develop sex-specific models to improve the prediction of ISec and IS by fasting measures in adults with overweight/obesity. A post hoc analysis was conducted on baseline data of two clinical trials completed between 2010 and 2020 (37 men and 61 postmenopausal women, 45-73 years, BMI > 25 kg/m, without chronic disease). Glucose-induced insulin or C-peptide secretions and IS were measured using gold-standard Botnia-clamps, which is a 1 h intravenous glucose tolerance test followed by a 3 h hyperinsulinemic-euglycemic clamp. Stepwise regression analysis using anthropometric and fasting plasma glucose, insulin, and lipoprotein-related measures was used to predict ISec and IS. First-phase, second-phase and total glucose-induced ISec were predicted by a combination of fasting plasma insulin and apoB without or with plasma glucose, triglyceride, and waist circumference in women (R = 0.58-0.69), and by plasma insulin and glucose without or with BMI and cholesterol in men (R = 0.41-0.83). Plasma C-peptide, alone in men or followed by glucose in women, predicted C-peptide secretion. IS was predicted by plasma insulin and waist circumference, followed by HDL-C in women (R = 0.57) or by glucose in men (R = 0.67). The sex-specific models agreed with the Botnia-clamp measurements of ISec and IS more than with HOMA or QUICKI. Sex-specific models incorporating anthropometric and lipoprotein-related parameters allowed better prediction of ISec and IS in subjects with overweight or obesity than current indices that rely on glucose and insulin alone.
在人类中，胰岛素分泌（ISec）和敏感性（IS）存在性别差异。然而，目前用于估计这些差异的空腹指标，如 HOMA 和 QUICKI，并不具有性别特异性。我们旨在开发性别特异性模型，以改善超重/肥胖成年人通过空腹测量来预测 ISec 和 IS。对 2010 年至 2020 年完成的两项临床试验的基线数据进行了事后分析（37 名男性和 61 名绝经后女性，45-73 岁，BMI > 25 kg/m，无慢性疾病）。使用金标准 Botnia 夹来测量葡萄糖诱导的胰岛素或 C 肽分泌和 IS，这是一个 1 小时静脉葡萄糖耐量试验，随后进行 3 小时高胰岛素-正常血糖钳夹。使用人体测量学和空腹血糖、胰岛素和脂蛋白相关指标的逐步回归分析来预测 ISec 和 IS。在女性中，第一相、第二相和总葡萄糖诱导的 ISec 由空腹血浆胰岛素和 apoB 预测，而无需或需要血糖、甘油三酯和腰围（R = 0.58-0.69），在男性中，由血浆胰岛素和血糖预测，而无需或需要 BMI 和胆固醇（R = 0.41-0.83）。血浆 C 肽在男性中单独预测或在女性中紧随葡萄糖预测 C 肽分泌。IS 由血浆胰岛素和腰围预测，随后在女性中由 HDL-C 预测（R = 0.57）或在男性中由血糖预测（R = 0.67）。性别特异性模型与 Botnia 夹测量的 ISec 和 IS 的一致性优于 HOMA 或 QUICKI。纳入人体测量学和脂蛋白相关参数的性别特异性模型比仅依赖血糖和胰岛素的现有指数更能预测超重或肥胖人群的 ISec 和 IS。
