Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA.
Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
Nutr Diabetes. 2024 Jul 10;14(1):50. doi: 10.1038/s41387-024-00269-3.
BACKGROUND/OBJECTIVE: To identify predictors of incident type 2 diabetes using a mixed meal tolerance test (MMTT).
Adult Indigenous Americans without diabetes (n = 501) from a longitudinal cohort underwent at baseline a 4-h MMTT, measures of body composition, an oral glucose tolerance test, an intravenous glucose tolerance test for acute insulin response (AIR), and a hyperinsulinemic-euglycemic clamp for insulin action (M). Plasma glucose responses from the MMTT were quantified by the total and incremental area under the curve (AUC/iAUC).
At follow-up (median time 9.6 [inter-quartile range: 5.6-13.5] years), 169 participants were diagnosed with diabetes. Unadjusted Cox proportional hazards models, glucose AUC (HR: 1.98, 95% CI: 1.67, 2.34, p < 0.0001), AUC (HR: 1.93, 95% CI: 1.62, 2.31, p < 0.0001), and iAUC (HR: 1.43, 95% CI: 1.20, 1.71, p < 0.0001) were associated with an increased risk of diabetes. After adjustment for covariates (age, sex, body fat percentage, M, AIR, Indigenous American heritage) in three subsequent models, AUC (HR: 1.44, 95% CI: 1.10, 1.88, p = 0.007) and AUC (HR: 1.41, 95% CI: 1.09, 1.84, p < 0.01) remained associated with increased risk of diabetes.
Glucose responses to a mixed meal predicted the development of type 2 diabetes. This indicates that a mixed nutritional challenge provides important information on disease risk.
ClinicalTrials.gov identifier : NCT00340132, NCT00339482.
背景/目的：使用混合餐耐量试验（MMTT）来确定 2 型糖尿病的预测因子。
来自一项纵向队列的未患糖尿病的成年印第安裔美国人（n=501）在基线时进行了 4 小时 MMTT、身体成分测量、口服葡萄糖耐量试验、急性胰岛素反应（AIR）的静脉葡萄糖耐量试验以及胰岛素作用的高胰岛素-正常血糖钳夹试验（M）。MMTT 的血浆葡萄糖反应通过总曲线下面积（AUC）和增量 AUC（iAUC）进行量化。
在随访（中位数时间为 9.6 年[四分位距：5.6-13.5]）期间，有 169 名参与者被诊断患有糖尿病。未调整的 Cox 比例风险模型显示，血糖 AUC（HR：1.98，95%CI：1.67，2.34，p<0.0001）、AUC（HR：1.93，95%CI：1.62，2.31，p<0.0001）和 iAUC（HR：1.43，95%CI：1.20，1.71，p<0.0001）与糖尿病风险增加相关。在随后的三个模型中，对协变量（年龄、性别、体脂百分比、M、AIR、印第安人血统）进行调整后，AUC（HR：1.44，95%CI：1.10，1.88，p=0.007）和 AUC（HR：1.41，95%CI：1.09，1.84，p<0.01）仍与糖尿病风险增加相关。
混合餐的血糖反应可预测 2 型糖尿病的发生。这表明混合营养挑战提供了有关疾病风险的重要信息。
ClinicalTrials.gov 标识符：NCT00340132，NCT00339482。
