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Hyperinsulinemia in individuals with obesity: Role of insulin clearance
Author(s) -
Kim Mee Kyoung,
Reaven Gerald M.,
Chen YiiDer Ida,
Kim Eric,
Kim Sun H.
Publication year - 2015
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.21256
Subject(s) - hyperinsulinemia , obesity , medicine , endocrinology , insulin , body mass index , insulin resistance , population , environmental health
Objective Several studies have shown decreased insulin clearance rate (ICR) in individuals with obesity, but it remains unclear whether this is predominately due to obesity‐associated insulin resistance (IR) or obesity itself. This study aimed to clarify the complex interrelationship that exists between obesity, IR, and ICR. Methods Healthy volunteers ( n = 277) had measurement of IR and ICR using the insulin suppression test (IST). IR was quantified by determining the steady‐state plasma glucose (SSPG) during the IST. ICR was estimated by dividing the insulin infusion rate by the steady‐state plasma insulin concentration. We performed our analysis by stratifying the experimental population into four dichotomous categories, varying in obesity and IR. Obesity was defined as a body mass index (BMI) ≥ 30 kg/m 2 , and IR was defined as SSPG ≥ 150 mg/dL. Results Individuals with obesity had higher fasting insulin compared with individuals without obesity, regardless of IR. ICR was similar between individuals with and without obesity but was higher in insulin resistant individuals compared with insulin‐sensitive individuals. In multivariate analysis, both fasting insulin and SSPG were significantly associated with ICR. No significant relationships were observed between BMI and ICR. Conclusions Reduced ICR in obesity is secondary to IR, not excess adiposity.