One-Hour Post-Load Glucose Is Associated with Multisystem Complications in People Living with Obesity

Area of Science:

• Metabolic Medicine
• Obesity Research
• Cardiometabolic Health

Background:

• Obesity is linked to numerous health complications that can precede type 2 diabetes mellitus (T2DM).
• Early identification of metabolic markers is crucial for stratifying risk and guiding therapeutic strategies for obesity-related complications.
• 1-hour post-load plasma glucose during an oral glucose tolerance test (OGTT) is a sensitive indicator of early dysglycemia and cardiometabolic risk.

Purpose of the Study:

• To investigate the association between 1-hour post-load plasma glucose levels during OGTT and established obesity-related complications.
• To assess the utility of 1-hour glucose as an early marker in adults with obesity but without T2DM.

Main Methods:

• An observational, cross-sectional study involving 47 adults with obesity without T2DM.
• Standard 75-g OGTT with plasma glucose and insulin measurements at fasting, 1-hour, and 2-hours.
• Retrospective data collection on obesity-related complications via questionnaires, clinical assessment, and medical records.

Main Results:

• Higher 1-hour post-load glucose levels were significantly associated with arterial hypertension, dyslipidemia, metabolic dysfunction-associated steatotic liver disease, impaired glucose tolerance, obesity hypoventilation syndrome, urinary incontinence, and chronic kidney disease.
• 1-hour glucose showed superior discriminatory capacity compared to fasting or 2-hour glucose levels for most complications.
• Insulin levels indicated generalized insulin resistance but had limited ability to differentiate complication phenotypes.

Conclusions:

• Elevated 1-hour post-load plasma glucose is consistently associated with multisystem complications in individuals with obesity and without T2DM.
• 1-hour post-load glucose serves as a clinically relevant integrated marker of metabolic and systemic burden in obesity.
• Findings support the use of 1-hour glucose for complication-driven risk stratification in obesity, though causality cannot be inferred due to study design.