Prediction of postprandial glycemic exposure: utility of fasting and 2-h glucose measurements alone and in combination with assessment of body composition, fitness, and strength.
OBJECTIVE
To determine the best predictors of total postprandial glycemic exposure and peak glucose concentrations in nondiabetic humans.


METHODS
Data from 203 nondiabetic volunteers who ingested a carbohydrate-containing mixed meal were analyzed.


RESULTS
Fasting glucose and insulin concentrations were poor predictors of postprandial glucose area above basal (R2 = approximately 0.07, P < 0.001). The correlation was stronger for 2-h glucose concentration (R2 = 0.55, P < 0.001) and improved slightly but significantly (P < 0.001) with the addition of fasting glucose, insulin, age, sex, and body weight to the model (r2 = 0.58). The 2-h glucose concentration also predicted the peak glucose concentration (R2 = 0.37, P < 0.001) with strength of the prediction increasing (P < 0.001) modestly with the addition of fasting glucose, insulin, age, sex, and body weight to the model (R2 = 0.48, P < 0.001). On the other hand, addition of measures of body function and composition did not improve prediction of total glycemic exposure or peak glucose concentration.


CONCLUSIONS
Isolated measures of fasting or 2-h glucose concentrations alone or in combination with more complex measures of body composition and function are poor predictors of postprandial glycemic exposure or peak glucose concentration. This may explain, at least in part, the weak and at times inconsistent relationship between these parameters and cardiovascular risk.
Cohen
Ohad
O
Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic Rochester, 200 First St. SW, Rm. 5-194 Joseph, Rochester, MN 55905, USA.
Basu
Rita
R
Bock
Gerlies
G
Dalla Man
Chiara
C
Campioni
Marco
M
Basu
Ananda
A
Toffolo
Gianna
G
Cobelli
Claudio
C
Rizza
Robert A
RA
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001823:Body Composition; D001835:Body Weight; D005215:Fasting; D005260:Female; D006801:Humans; D008297:Male; D008954:Models, Biological; D010809:Physical Fitness; D019518:Postprandial Period; D012016:Reference Values; D015203:Reproducibility of Results
D001786:Blood Glucose