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Longitudinal Changes in Insulin Resistance in Normal Weight, Overweight and Obese Individuals
Alice Tang1,2, Adelle C F Coster3, Katherine T Tonks4,5,6
1Diabetes and Metabolism Division, Garvan Institute of Medical Research, Sydney 2010, Australia. a.tang@unswalumni.com.
Journal of Clinical Medicine
|May 11, 2019
Summary
Insulin sensitivity in overweight and obese individuals remained stable over time, but insulin resistance predicted worsening metabolic health. Baseline insulin sensitivity was a strong predictor of follow-up insulin sensitivity.
Area of Science:
- Metabolic Health
- Obesity Research
- Insulin Sensitivity Dynamics
Background:
- Longitudinal studies suggest metabolic health in obesity declines with age.
- This study investigates the long-term changes in insulin sensitivity in overweight and obese individuals.
Purpose of the Study:
- To assess the persistence of insulin sensitivity over time in overweight and obese individuals.
- To determine if baseline insulin sensitivity predicts future metabolic health outcomes.
Main Methods:
- Hyperinsulinaemic-euglycaemic clamp used to measure insulin sensitivity (M/I) in 99 individuals (Lean, Obese-Sensitive, Obese-Resistant).
- 57 participants completed a 5.4-year follow-up with repeated clamp measurements, body composition (DXA), and cardiovascular markers.
- Liver fat content assessed via CT and MRI.
Main Results:
- Insulin sensitivity (M/I) did not change significantly over time in the cohort.
- Insulin-sensitive obese individuals (ObSen) maintained higher insulin sensitivity than insulin-resistant obese individuals (ObRes) at follow-up.
- Android and visceral fat, and systolic blood pressure increased significantly over time, primarily driven by the ObRes group.
- Baseline insulin sensitivity strongly correlated with follow-up insulin sensitivity (r=0.76).
Conclusions:
- Insulin sensitivity is relatively stable over time in overweight and obese individuals.
- Individuals with baseline insulin resistance are prone to further metabolic deterioration.
- Baseline insulin sensitivity is a key determinant of long-term metabolic health in obesity.
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