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. 2012 Jul;161(1):51-7.
doi: 10.1016/j.jpeds.2011.12.050. Epub 2012 Feb 9.

Oral disposition index in obese youth from normal to prediabetes to diabetes: relationship to clamp disposition index

Lindsey George Sjaarda  1 , Fida Bacha, Sojung Lee, Hala Tfayli, Elisa Andreatta, Silva Arslanian
Affiliations

Oral disposition index in obese youth from normal to prediabetes to diabetes: relationship to clamp disposition index

Lindsey George Sjaarda et al. J Pediatr. 2012 Jul.

Abstract

Objective: We sought to assess the glucose disposition index using an oral glucose tolerance test (OGTT; oDI) compared with the glucose disposition index measured from the combination of the euglycemic-hyperinsulinemic and hyperglycemic clamps (cDI) in obese pediatric subjects spanning the range of glucose tolerance.

Study design: Overweight/obese adolescents (n = 185) with varying glucose tolerance (87 normal, 54 impaired, 31 with type 2 diabetes, and 13 with type 1 diabetes) completed an OGTT and both a hyperinsulinemic-euglycemic and a hyperglycemic clamp study. Indices of insulin sensitivity and β-cell function were calculated, and 4 different oDI estimates were calculated as the products of insulin and C-peptide-based sensitivity and secretion indices.

Results: Mirroring the differences across groups by cDI, the oDI estimates were greatest in normal glucose tolerance adolescents and lowest in type 2 diabetes mellitus and obese with type 1 diabetes mellitus adolescents. The insulin-based oDI estimates correlated with cDI overall (r ≥ 0.74, P < .001) and within each glucose tolerance group (r ≥ 0.40, P < .001). Also, oDI and cDI predicted 2-hour OGTT glucose similarly.

Conclusions: The oDI is a simple surrogate estimate of β-cell function relative to insulin sensitivity that can be applied to obese adolescents with varying glucose tolerance in large-scale epidemiological studies where the applicability of clamp studies is limited due to feasibility, cost, and labor intensiveness.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Scatter plots with correlations of the four oral DI (oDI) estimates (rows 1 and 2: insulin-based oDI, rows 3 and 4: C-peptide-based oDI) compared with clamp DI (cDI) in all the groups combined and in each glucose tolerance category (columns) separately.
Figure 2
Figure 2
Linear regression analysis of log-transformed clamp DI (cDI) (A) or oral DI derived from 1/fasting insulin × insulinogenic index (IF oDI) (B) on log-transformed 2-hr glucose concentration from the oral glucose tolerance test (OGTT).
See this image and copyright information in PMC

Comment in

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