title: Glycaemic fall after a glucose load. A population-based study.
abstract: 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.
authors.affiliation: Department of Clinical and Experimental Medicine, Chair of Internal Medicine, University of Padova, Padova, Italy. edoardo.casiglia@unipd.it
authors.forename: E
authors.initials: E
authors.lastname: Casiglia
authors.forename: V
authors.initials: V
authors.lastname: Tikhonoff
authors.forename: S
authors.initials: S
authors.lastname: Caffi
authors.forename: A
authors.initials: A
authors.lastname: Bascelli
authors.forename: F
authors.initials: F
authors.lastname: Guglielmi
authors.forename: A
authors.initials: A
authors.lastname: Mazza
authors.forename: B
authors.initials: B
authors.lastname: Martini
authors.forename: M
authors.initials: M
authors.lastname: Saugo
authors.forename: D
authors.initials: D
authors.lastname: D'Este
authors.forename: S
authors.initials: S
authors.lastname: Masiero
authors.forename: F
authors.initials: F
authors.lastname: Guidotti
authors.forename: G
authors.initials: G
authors.lastname: Boschetti
authors.forename: L
authors.initials: L
authors.lastname: Schiavon
authors.forename: P
authors.initials: P
authors.lastname: Spinella
authors.forename: S V
authors.initials: SV
authors.lastname: de Kreutzenberg
authors.forename: F
authors.initials: F
authors.lastname: De Lazzari
authors.forename: A C
authors.initials: AC
authors.lastname: Pessina
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D007328:Insulin