Objectives In obese adults the shape of the glucose response curve during an oral glucose tolerance test (OGTT) predicts future type 2 diabetes. Patients with an incessant increase or monophasic curves have increased risk compared to those with biphasic curves. Since type 2 diabetes is associated with increased cardiometabolic risk, we studied whether differences in OGTT response curve are associated with differences in cardiometabolic risk factors in healthy adolescents across a wide body mass index (BMI) range. Methods Sixty-nine (33F/36M), white adolescents (age: 15.2 ± 1.7 years; BMI: 21.5 ± 4.7 kg/m 2 ; mean ± SD) were studied. Risk factors measured included percent body fat, blood pressure, lipids, augmentation index, reactive hyperemia, endothelin 1, plasminogen activator 1, inflammatory markers (interleukin 6, c-reactive protein), insulin secretion, insulin sensitivity (Matusda index), and disposition index (DI). Results Thirty-two subjects had biphasic responses; 35 subjects had monophasic responses and two females had incessant increases. Sex did not affect the frequency of responses. Glucose area under the curve during OGTT was greater in those with a mono vs. biphasic curves (p=0.01). Disposition index was markedly lower in subjects with a monophasic curve than in those with a biphasic curve (3.6 [2.3–5.0] vs. 5.8 [3.8–7.6], median [25th, 75th%] p=0.003). Triglyceride to high-density lipoprotein cholesterol (HDL) ratio was higher in subjects with a monophasic curve (p=0.046). Conclusions The decreased disposition index indicates that in healthy adolescents a monophasic response to OGTT is due to decreased insulin secretion relative to the degree of insulin resistance present. This was not associated with differences in most other cardiometabolic risk markers. Trial registration Clinical Trials.gov, NCT02821104.

中文翻译：

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口服葡萄糖耐量反应曲线可预测健康青少年的处置指数而非其他心脏代谢危险因素

目的 在肥胖成人中，口服葡萄糖耐量试验 (OGTT) 期间葡萄糖反应曲线的形状可预测未来的 2 型糖尿病。与具有双相曲线的患者相比，具有持续增加或单相曲线的患者具有增加的风险。由于 2 型糖尿病与心脏代谢风险增加有关，我们研究了 OGTT 反应曲线的差异是否与健康青少年在广泛的体重指数 (BMI) 范围内的心脏代谢风险因素的差异相关。方法 研究了 69 名 (33F/36M) 白人青少年（年龄：15.2 ± 1.7 岁；BMI：21.5 ± 4.7 kg/m 2 ；平均值 ± SD）。测量的风险因素包括体脂百分比、血压、血脂、增强指数、反应性充血、内皮素 1、纤溶酶原激活物 1、炎症标志物（白细胞介素 6、c-反应蛋白）、胰岛素分泌、胰岛素敏感性（Matusda 指数）和处置指数 (DI)。结果 32 名受试者有双相反应；35 名受试者有单相反应，两名女性有持续增加。性别不影响反应频率。OGTT 期间曲线下的葡萄糖面积在具有单相曲线和双相曲线的那些中更大 (p=0.01)。具有单相曲线的受试者的处置指数明显低于具有双相曲线的受试者（3.6 [2.3–5.0] 对 5.8 [3.8–7.6]，中位数 [25%，75%] p=0.003）。具有单相曲线的受试者的甘油三酯与高密度脂蛋白胆固醇 (HDL) 的比率更高 (p=0.046)。结论 降低的处置指数表明，在健康青少年中，对 OGTT 的单相反应是由于相对于存在的胰岛素抵抗程度的胰岛素分泌减少。这与大多数其他心脏代谢风险标志物的差异无关。试验注册 Clinical Trials.gov，NCT02821104。