Higher incremental insulin area under the curve during oral glucose tolerance test predicts less food intake and weight gain
2011
Objective: To investigate the correlation of peripheral insulin concentrations with food intake and body weight. Design: Cross sectional and longitudinal clinical study: we investigated the association of peripheral insulin concentrations in response to an oral glucose tolerance test (OGTT) with subsequent measures of ad libitum food intake and body weight change. Subjects: Food intake analysis: Pima Indians (n=67, 63% male; body mass index (mean±s.d.) 34.2±9.4 kg m−2) with normal glucose regulation (NGR; fasting glucose <5.6 mmol l−1 and 2-h glucose <7.8 mmol l−1) participated in a study of ad libitum food intake measured over 3 days by an automated vending machine system. Weight change analysis: Pima Indians with NGR (n=339) who also participated in a longitudinal study of risks for type 2 diabetes and had follow-up weights. Results: Food intake analysis: incremental area under the curve (iAUC) for insulin during the OGTT was negatively associated with mean daily ad libitum energy intake (DEI) (r=−0.26, P=0.04), calories consumed as percent weight-maintenance energy needs (%WMEN) (r=−0.38, P=0.002) and carbohydrate intake (gram per day) (r=−0.35, P=0.005). Adjustment for age and sex attenuated the association of iAUC with DEI (P=0.06) not with %WMEN and carbohydrate intake (P=0.005, P=0.008). Weight change analysis: after adjustment for age, sex, follow-up time and initial body weight, higher insulin iAUC predicted less absolute and percent weight change (β=−6.9, P=0.02; β=−0.08, P=0.008, respectively). Conclusions: In healthy Pima Indians with NGR, higher plasma iAUC during an OGTT predicted lower food intake and carbohydrate consumption and less weight gain. These data indicated a role for peripheral insulin as a negative feedback signal in the regulation of energy intake and body weight.
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