Fasting glucagon concentrations are associated with longitudinal decline of β-cell function in non-diabetic humans

JD Adams, C Dalla Man, MC Laurenti, MDH Andrade… - Metabolism, 2020 - Elsevier
Metabolism, 2020Elsevier
Purpose Abnormal glucagon concentrations are a feature of prediabetes but it is uncertain if
α-cell dysfunction contributes to a longitudinal decline in β-cell function. We therefore sought
to determine if a decline in β-cell function is associated with a higher nadir glucagon in the
postprandial period or with higher fasting glucagon. Methods This was a longitudinal study
in which 73 non-diabetic subjects were studied on 2 occasions 6.6±0.3 years apart using a 2-
hour, 7-sample oral glucose tolerance test. Disposition Index (DI) was calculated using the …
Purpose
Abnormal glucagon concentrations are a feature of prediabetes but it is uncertain if α-cell dysfunction contributes to a longitudinal decline in β-cell function. We therefore sought to determine if a decline in β-cell function is associated with a higher nadir glucagon in the postprandial period or with higher fasting glucagon.
Methods
This was a longitudinal study in which 73 non-diabetic subjects were studied on 2 occasions 6.6 ± 0.3 years apart using a 2-hour, 7-sample oral glucose tolerance test. Disposition Index (DI) was calculated using the oral minimal model applied to the measurements of glucose, insulin, C-peptide concentrations during the studies. We subsequently examined the relationship of glucagon concentrations at baseline with change in DI (used as a measure of β-cell function) after adjusting for changes in weight and the baseline value of DI.
Results
After adjusting for covariates, nadir postprandial glucagon concentrations were not associated with changes in β-cell function as quantified by DI. On the other hand, fasting glucagon concentrations during the baseline study were inversely correlated with longitudinal changes in DI.
Conclusions
Defects in α-cell function, manifest as elevated fasting glucagon, are associated with a subsequent decline in β-cell function. It remains to be ascertained if abnormal α-cell function contributes directly to loss of β-cell secretory capacity in the pathogenesis of type 2 diabetes.
Elsevier
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