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Incretin and islet hormone responses to meals of increasing size in healthy subjects.
J Clin Endocrinol Metab. 2015 Feb; 100(2):561-8.JC

Abstract

CONTEXT

Postprandial glucose homeostasis is regulated through the secretion of glucagon-like peptide 1 (GLP-1) through the stimulation of insulin secretion and inhibition of glucagon secretion. However, how these processes dynamically adapt to demands created by caloric challenges achieved during daily life is not known.

OBJECTIVE

The objective of the study was to explore the adaptation of incretin and islet hormones after mixed meals of increasing size in healthy subjects.

DESIGN

Twenty-four healthy lean subjects ingested a standard breakfast after an overnight fast followed, after 4 hours, by a lunch of a different size (511, 743, and 1034 kcal) but with identical nutrient composition together with 1.5 g paracetamol. Glucose, insulin, C-peptide, glucagon, intact GLP-1, and glucose-dependent insulinotropic polypeptide (GIP) and paracetamol were measured after the meals.

MAIN OUTCOME MEASURE

Area under the 180-minute curve (AUC) for insulin, C-peptide, glucagon, GLP-1, and GIP and model-derived β-cell function and paracetamol appearance were calculated.

RESULTS

Glucose profiles were similar after the two larger meals, whereas after the smaller meal, there was a postpeak reduction below baseline to a nadir of 3.8 ± 0.1 mmol/L after 75 minutes (P < .001). The AUC for GLP-1, GIP, insulin, and C-peptide were significantly higher by increasing the caloric load as was β-cell sensitivity to glucose. In contrast, the AUC glucagon was the same for all three meals, although there was an increase in glucagon after the postpeak glucose reduction in the smaller meal. The 0- to 20-minute paracetamol appearance was increased by increasing meal size.

CONCLUSION

Mixed lunch meals of increasing size elicit a caloric-dependent insulin response due to increased β-cell secretion achieved by increased GIP and GLP-1 levels. The adaptation at larger meals results in identical glucose excursions, whereas after a lower caloric lunch, the insulin response is high, resulting in a postpeak suppression of glucose below baseline.

Authors+Show Affiliations

Department of Clinical Sciences (W.A., B.O., B.A.), Lund University, 221 84 Lund, Sweden; and Metabolic Unit (G.P., R.B., A.M.), Institute of Biomedical Engineering, Consiglio Nazionale delle Ricerche, 35127 Padova, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25375983

Citation

Alsalim, Wathik, et al. "Incretin and Islet Hormone Responses to Meals of Increasing Size in Healthy Subjects." The Journal of Clinical Endocrinology and Metabolism, vol. 100, no. 2, 2015, pp. 561-8.
Alsalim W, Omar B, Pacini G, et al. Incretin and islet hormone responses to meals of increasing size in healthy subjects. J Clin Endocrinol Metab. 2015;100(2):561-8.
Alsalim, W., Omar, B., Pacini, G., Bizzotto, R., Mari, A., & Ahrén, B. (2015). Incretin and islet hormone responses to meals of increasing size in healthy subjects. The Journal of Clinical Endocrinology and Metabolism, 100(2), 561-8. https://doi.org/10.1210/jc.2014-2865
Alsalim W, et al. Incretin and Islet Hormone Responses to Meals of Increasing Size in Healthy Subjects. J Clin Endocrinol Metab. 2015;100(2):561-8. PubMed PMID: 25375983.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incretin and islet hormone responses to meals of increasing size in healthy subjects. AU - Alsalim,Wathik, AU - Omar,Bilal, AU - Pacini,Giovanni, AU - Bizzotto,Roberto, AU - Mari,Andrea, AU - Ahrén,Bo, Y1 - 2014/11/06/ PY - 2014/11/7/entrez PY - 2014/11/7/pubmed PY - 2015/4/15/medline SP - 561 EP - 8 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 100 IS - 2 N2 - CONTEXT: Postprandial glucose homeostasis is regulated through the secretion of glucagon-like peptide 1 (GLP-1) through the stimulation of insulin secretion and inhibition of glucagon secretion. However, how these processes dynamically adapt to demands created by caloric challenges achieved during daily life is not known. OBJECTIVE: The objective of the study was to explore the adaptation of incretin and islet hormones after mixed meals of increasing size in healthy subjects. DESIGN: Twenty-four healthy lean subjects ingested a standard breakfast after an overnight fast followed, after 4 hours, by a lunch of a different size (511, 743, and 1034 kcal) but with identical nutrient composition together with 1.5 g paracetamol. Glucose, insulin, C-peptide, glucagon, intact GLP-1, and glucose-dependent insulinotropic polypeptide (GIP) and paracetamol were measured after the meals. MAIN OUTCOME MEASURE: Area under the 180-minute curve (AUC) for insulin, C-peptide, glucagon, GLP-1, and GIP and model-derived β-cell function and paracetamol appearance were calculated. RESULTS: Glucose profiles were similar after the two larger meals, whereas after the smaller meal, there was a postpeak reduction below baseline to a nadir of 3.8 ± 0.1 mmol/L after 75 minutes (P < .001). The AUC for GLP-1, GIP, insulin, and C-peptide were significantly higher by increasing the caloric load as was β-cell sensitivity to glucose. In contrast, the AUC glucagon was the same for all three meals, although there was an increase in glucagon after the postpeak glucose reduction in the smaller meal. The 0- to 20-minute paracetamol appearance was increased by increasing meal size. CONCLUSION: Mixed lunch meals of increasing size elicit a caloric-dependent insulin response due to increased β-cell secretion achieved by increased GIP and GLP-1 levels. The adaptation at larger meals results in identical glucose excursions, whereas after a lower caloric lunch, the insulin response is high, resulting in a postpeak suppression of glucose below baseline. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/25375983/Incretin_and_islet_hormone_responses_to_meals_of_increasing_size_in_healthy_subjects_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2014-2865 DB - PRIME DP - Unbound Medicine ER -