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Kidney function, β-cell function and glucose tolerance in older men
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2015 (English)In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 100, no 2, 587-593 p.Article in journal (Refereed) Published
Abstract [en]

Context: Kidney dysfunction induces insulin resistance, but it is unknown if β cell function is affected.

Objective: To investigate insulin release (β cell function) and glucose tolerance following a standardized oral glucose tolerance test (OGTT) across kidney function strata.

Setting and Design: Community-based cohort study from the Uppsala Longitudinal Study of Adult Men (ULSAM).

Participants and Main Outcome Measure: Included were 1015 non-diabetic Swedish men aged 70-71 years. All participants underwent OGTT and euglycaemic hyperinsulinaemic clamp (HEGC) tests, allowing determination of insulin sensitivity, β cell function and glucose tolerance. Kidney function was estimated by cystatin C-algorithms. Mixed models were used to identify determinants of insulin secretion after the hyperglycemic load.

Results: As many as 466 (46%) of participants presented moderate-advanced kidney disease. Insulin sensitivity (by HEGC) decreased across decreasing kidney function quartiles. After the OGTT challenge, however, β cell function indices (area under the curve for insulin release, the estimated first phase insulin release and the insulinogenic index) were incrementally higher. Neither the oral disposition index nor ths 2-hour post-load glucose tolerance differed across kidney function strata. Mixed models showed that dynamic insulin release during the OGTT was inversely associated to kidney function despite correction for each individual's insulin sensitivity or its risk factors.

Conclusions: In older men, β cell function after a hyperglycemic load appropriately compensated the loss in insulin sensitivity that accompanies kidney dysfunction. As a result, the net balance between insulin sensitivity and β cell function was preserved.

Place, publisher, year, edition, pages
2015. Vol. 100, no 2, 587-593 p.
National Category
Clinical Medicine
Research subject
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Identifiers
URN: urn:nbn:se:du-16606DOI: 10.1210/jc.2014-3313ISI: 000353350900063PubMedID: 25429626OAI: oai:DiVA.org:du-16606DiVA: diva2:775981
Available from: 2015-01-05 Created: 2015-01-05 Last updated: 2015-05-18Bibliographically approved

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CiteExportLink to record
Permanent link

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Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
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  • en-US
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  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
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Output format
  • html
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