Highlights
- •Hyperinsulinaemia is associated with many metabolic diseases, including vascular disease.
- •We examined a large database of more than 7000 oral glucose tolerance tests with insulin assay.
- •People with type 2 diabetes or impaired glucose tolerance have high and sustained insulin levels.
- •Most people with normal glucose tolerance have high insulin levels independent of obesity.
- •Dynamic insulin patterning may be a useful tool for diagnosing hyperinsulinaemia.
Abstract
Objective
Hyperinsulinaemia is associated with development of chronic metabolic disease and
is emerging as a health risk independent to that of insulin resistance. However, little
is known to what extent hyperinsulinaemia occurs with normal glucose tolerance in
lean subjects.
Method
Oral glucose tolerance tests with concurrent insulin assay were conducted during the
1970s–1990s. Participants were classified according to glucose tolerance and insulin
response pattern. Analysis of variance compared differences in plasma glucose, plasma
insulin, and demographic and metabolic risk factors between groups.
Results
Participants with normal glucose tolerance comprised 54% (n = 4185) of the total cohort. Of these, just over half (n = 2079) showed hyperinsulinaemia despite normal glucose clearance. Obesity had a modest
association with hyperinsulinaemia in people with normal glucose tolerance. Fasting
insulin had limited value in diagnosing hyperinsulinaemia. The majority of participants
(93%) with impaired glucose tolerance or diabetes had concurrent hyperinsulinaemia.
Conclusion
Hyperinsulinaemia in the absence of impaired glucose tolerance may provide the earliest
detection for metabolic disease risk and likely occurs in a substantial proportion
of an otherwise healthy population. Dynamic insulin patterning may produce more meaningful
and potentially helpful diagnoses. Further research is needed to investigate clinically
useful hyperinsulinaemia screening tools.
Keywords
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Article info
Publication history
Published online: June 17, 2016
Accepted:
June 6,
2016
Received in revised form:
February 3,
2016
Received:
July 10,
2015
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
