Glycaemic fall after a glucose load. A population-based study.
OBJECTIVE
A blood glucose (BG) fall after an oral glucose load has never been described previously at a population level. This study was aimed at looking for a plasma glucose trend after an oral glucose load for possible blood glucose fall if any, and for its impact on coronary mortality at a population level.


RESULTS
In subjects from an unselected general population, BG and insulin were detected before and 1 and 2h after a 75-g oral glucose load for insulin sensitivity and β-cell function determination. Blood pressure, blood examinations and left ventricular mass were measured, and mortality was monitored for 18.8±7.7 years. According to discriminant analysis, the population was stratified into cluster 0 (1-h BG < fasting BG; n=497) and cluster 1 (1-h BG ≥ fasting BG; n=1733). To avoid any interference of age and sex, statistical analysis was limited to two age-gender-matched cohorts of 490 subjects from each cluster (n=940). Subjects in cluster 0 showed significantly higher insulin sensitivity and β-cell function, lower visceral adiposity and lower blood pressure values. Adjusted coronary mortality was 8 times lower in cluster 0 than 1 (p<0.001). The relative risk of belonging to cluster 1 was 5.40 (95% CI 2.22-13.1).


CONCLUSIONS
It seems that two clusters exist in the general population with respect to their response to an oral glucose load, independent of age and gender. Subjects who respond with a BG decrease could represent a privileged sub-population, where insulin sensitivity and β-cell function are better, some risk factors are less prevalent, and coronary mortality is lower.
Casiglia
E
E
Department of Clinical and Experimental Medicine, Chair of Internal Medicine, University of Padova, Padova, Italy. edoardo.casiglia@unipd.it
Tikhonoff
V
V
Caffi
S
S
Bascelli
A
A
Guglielmi
F
F
Mazza
A
A
Martini
B
B
Saugo
M
M
D'Este
D
D
Masiero
S
S
Guidotti
F
F
Boschetti
G
G
Schiavon
L
L
Spinella
P
P
de Kreutzenberg
S V
SV
De Lazzari
F
F
Pessina
A C
AC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D016000:Cluster Analysis; D003327:Coronary Disease / Q000401:mortality / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D038321:Glycemic Index; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012307:Risk Factors; D055815:Young Adult
D001786:Blood Glucose; D007328:Insulin