Premium
Hepatic insulin clearance is the primary determinant of insulin sensitivity in the normal dog
Author(s) -
Ader Marilyn,
Stefanovski Darko,
Kim Stella P.,
Richey Joyce M.,
Ionut Viorica,
Catalano Karyn J.,
Hucking Katrin,
Ellmerer Martin,
Citters Gregg,
Hsu Isabel R.,
Chiu Jenny D.,
Woolcott Orison O.,
Harrison Lisa N.,
Zheng Dan,
Lottati Maya,
Kolka Cathryn M.,
Mooradian Vahe,
Dittmann Justin,
Yae Sophia,
Liu Huiwen,
Castro Ana Valeria B.,
Kabir Morvarid,
Bergman Richard N.
Publication year - 2014
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.20625
Subject(s) - hyperinsulinemia , medicine , endocrinology , insulin resistance , insulin , glucose clamp technique , obesity , type 2 diabetes , clamp , diabetes mellitus , insulin sensitivity , mechanical engineering , clamping , engineering
Objective Insulin resistance is a powerful risk factor for Type 2 diabetes and a constellation of chronic diseases, and is most commonly associated with obesity. We examined if factors other than obesity are more substantial predictors of insulin sensitivity under baseline, nonstimulated conditions. Methods Metabolic assessment was performed in healthy dogs ( n = 90). Whole‐body sensitivity from euglycemic clamps (SI CLAMP ) was the primary outcome variable, and was measured independently by IVGTT ( n = 36). Adiposity was measured by MRI ( n = 90), and glucose‐stimulated insulin response was measured from hyperglycemic clamp or IVGTT ( n = 86 and 36, respectively). Results SI CLAMP was highly variable (5.9‐75.9 dl/min per kg per μU/ml). Despite narrow range of body weight (mean, 28.7 ± 0.3 kg), adiposity varied approximately eight‐fold and was inversely correlated with SI CLAMP ( P < 0.025). SI CLAMP was negatively associated with fasting insulin, but most strongly associated with insulin clearance. Clearance was the dominant factor associated with sensitivity ( r = 0.53, P < 0.00001), whether calculated from clamp or IVGTT. Conclusions These data suggest that insulin clearance contributes substantially to insulin sensitivity, and may be pivotal in understanding the pathogenesis of insulin resistance. We propose the hyperinsulinemia due to reduction in insulin clearance is responsible for insulin resistance secondary to changes in body weight.