Postchallenge hyperglycemia in subjects with low body weight: implication for small glucose volume

Area of Science:

• Metabolic research
• Human physiology
• Endocrinology

Background:

• Postchallenge hyperglycemia is a concern in metabolic health.
• The role of glucose volume (GV) in hyperglycemia, particularly in low body weight (BW) individuals, requires further investigation.

Purpose of the Study:

• To test the hypothesis that postchallenge hyperglycemia in low BW subjects is partly due to small GV.
• To investigate the relationship between BW, glucose metabolism, and incident diabetes.

Main Methods:

• Studied 11,411 nondiabetic subjects, with a subset followed for 5.3 years.
• Assessed insulin sensitivity, secretion, and action in 1,537 subjects.
• Calculated corrected 2-hour plasma glucose (2hPGcorr) using extracellular water (ECW) as a GV surrogate.

Main Results:

• BW positively correlated with fasting plasma glucose (FPG) across its range.
• A nonlinear, J-shaped correlation was observed between BW and 2-hour plasma glucose (2hPG) and plasma glucose increment (δPG).
• In low BW subjects (≤59 kg), insulin sensitivity, secretion, and action were normal, with lower incident diabetes rates compared to heavier individuals. Corrected 2hPG (2hPGcorr) showed a linear correlation with BW, mitigating the J-shaped relationship.

Conclusions:

• Postchallenge hyperglycemia in low BW subjects is partly attributable to a smaller glucose volume (GV).
• Impaired glucose metabolism does not appear to be the primary driver of hyperglycemia in this cohort.
• GV correction provides a more accurate assessment of glucose metabolism in individuals with varying body weights.