Mechanism of increased plasma glucose levels after oral glucose ingestion in normal-weight middle-aged subjects.
OBJECTIVE
To determine the decline in glucose tolerance in normal-weight middle-aged subjects, we performed a cross-sectional study using double-labelled oral glucose tolerance tests in 8 middle-aged (46.3 +/- 0.9 years) and in 8 young (23.6 +/- 0.5) subjects with similar normal body weight.


METHODS
Plasma glucose was labelled by an infusion of dideuterated glucose started 120 min before ingestion of 1 g/kg of naturally (13)C-enriched corn starch glucose. Glucose levels, substrate oxidation (indirect calorimetry) and exogenous glucose oxidation ((13)C enrichment of expired CO(2)) were monitored for 330 min.


RESULTS
In the middle-aged subjects, the appearance of exogenous glucose was reduced (723 +/- 52 mg/kg/330 min) compared to young subjects (864 +/- 38; p < 0.05), and systemic glucose production was normal. Plasma glucose levels were increased due to a reduced glucose disappearance rate (middle aged: 1,046 +/- 61 mg/kg/330 min vs. young 1,242 +/- 67; p < 0.05), concerning both oxidative and non-oxidative disposal. This reduction was no longer apparent when the results were normalized for fat-free mass. Insulin levels were similar in young and middle-aged subjects.


CONCLUSIONS
In normal-weight middle-aged individuals, glucose intolerance is mainly due to the reduction in the mass of fat-free glucose-utilizing tissues. The higher plasma glucose levels enable normal glucose supply to peripheral tissues, and increase splanchnic glucose uptake.
Service de Nutrition et Diabétologie, Hôpital Haut-Lévêque, Pessac, France. vincent.rigalleau@wanadoo.fr
Vincent
V
Rigalleau
Michel
M
Beylot
Sylvie
S
Normand
Christiane
C
Pachiaudi
Martine
M
Laville
Cyril
C
Petitbois
Gérard
G
Deleris
Laurence
L
Baillet
Henri
H
Gin
D000328:Adult; D000375:Aging / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism*; D001823:Body Composition; D001835:Body Weight / Q000502:physiology; D017097:Electric Impedance; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005947:Glucose / Q000493:pharmacokinetics*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D012016:Reference Values
D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D005947:Glucose