Abstract | OBJECTIVE: The objective was to test the clinical utility of Quantose M(Q) to monitor changes in insulin sensitivity after pioglitazone therapy in prediabetic subjects. Quantose M(Q) is derived from fasting measurements of insulin, α-hydroxybutyrate, linoleoyl-glycerophosphocholine, and oleate, three nonglucose metabolites shown to correlate with insulin-stimulated glucose disposal. RESEARCH DESIGN AND METHODS: RESULTS:
Pioglitazone treatment lowered IGT conversion to diabetes (hazard ratio = 0.25; 95% confidence interval = 0.13-0.50; P < .0001). Although glycated hemoglobin did not track with insulin sensitivity, Quantose M(Q) increased in pioglitazone-treated subjects (by 1.45 [3.45] mg·min(-1)·kgwbm(-1)) (median [interquartile range]) (P < .001 vs placebo), as did the Matsuda index (by 3.05 [4.77] units; P < .0001). Quantose M(Q) correlated with the Matsuda index at baseline and change in the Matsuda index from baseline (rho, 0.85 and 0.79, respectively; P < .0001) and was progressively higher across closeout glucose tolerance status (diabetes, IGT, normal glucose tolerance). In logistic models including only anthropometric and fasting measurements, Quantose M(Q) outperformed both Matsuda and fasting insulin in predicting incident diabetes. CONCLUSIONS:
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Authors | Devjit Tripathy, Jeff E Cobb, Walter Gall, Klaus-Peter Adam, Tabitha George, Dawn C Schwenke, MaryAnn Banerji, George A Bray, Thomas A Buchanan, Stephen C Clement, Robert R Henry, Abbas E Kitabchi, Sunder Mudaliar, Robert E Ratner, Frankie B Stentz, Peter D Reaven, Nicolas Musi, Ele Ferrannini, Ralph A DeFronzo |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 100
Issue 5
Pg. 1855-62
(May 2015)
ISSN: 1945-7197 [Electronic] United States |
PMID | 25603459
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
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Chemical References |
- Blood Glucose
- Hypoglycemic Agents
- Insulin
- Thiazolidinediones
- Pioglitazone
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Topics |
- Adult
- Aged
- Blood Glucose
(metabolism)
- Diabetes Mellitus, Type 2
(metabolism, prevention & control)
- Female
- Glucose Intolerance
(diagnosis, metabolism)
- Glucose Tolerance Test
- Humans
- Hypoglycemic Agents
(therapeutic use)
- Insulin
(blood)
- Insulin Resistance
(physiology)
- Male
- Middle Aged
- Pioglitazone
- Prediabetic State
(drug therapy, metabolism)
- Thiazolidinediones
(therapeutic use)
- Treatment Outcome
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