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Endocrine Abstracts (2019) 67 O59 | DOI: 10.1530/endoabs.67.O59

EYES2019 7th ESE Young Endocrinologists and Scientists (EYES) Meeting Oral Presentations (67 abstracts)

Reduced insulin clearance relates to increased liver fat content in recent-onset type 2 diabetes and to impaired glucose control in recent-onset type 1 diabetes

Sofia Antoniou 2, , Oana P Zaharia 2, , Pavel Bobrov 3, , Klaus Strassburger 3, , Yanislava Karusheva 2, , Kálmán Bódis 1, , Yuliya Kupriyanova 2, , Volker Burkart 2, , Jong-Hee Hwang 2, , Karsten Müssig 1, , Amalia Gastaldelli 5, , Michael Roden 1, & Julia Szendroedi 1,

1Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; 2Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany; 3German Center for Diabetes Research (DZD), München-Neuherberg, Germany; 4Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany; 5Department of Medicine, Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States of America; 6Institute of Clinical Physiology Consiglio Nazionale delle Ricerche, Pisa Italy.

Objective: Insulin clearance can be lower in longstanding insulin-resistant states, whereas hepatic insulin kinetics are not yet clear in newly diagnosed diabetes mellitus.

Methods: Volunteers with type 1 (T1D; n=276, 66% male) or type 2 diabetes (T2D; n=451, 69%) and glucose-tolerant humans (CON; n=143, 65%) underwent hyperinsulinemic-euglycemic clamps to assess whole-body insulin sensitivity (M-value) and whole-body insulin clearance (ICWBIC, ml*kg−1*min−1). Hepatic insulin clearance was calculated from the areas under the curve of plasma C-peptide and insulin during intravenous glucose tolerance (ICIVGTT, 0–60 min) and mixed-meal tolerance tests (ICMMT, 0–180 min). Hepatocellular lipid content (HCL) was measured by 1H-magnetic resonance spectroscopy. Analyses were adjusted for age, sex and BMI.

Results: Compared to T2D and CON, T1D had a lower ICIVGTT (7.9±5.4 vs. 10.6±3.6 and 10.7±3.1, all P < 0.05) as well as ICMMT (5.9±2.8 vs. 9.9±31.4 and 8.6±2.3, all P < 0.05), which in turn correlated negatively with HbA1c (r=−0.234 and r=−0.029, both P < 0.05). In T2D, ICIVGTT was positively correlated with M-value (r=0.379, P < 0.05). T2D patients with hepatic steatosis (n=76) had 8% and 7% lower ICWBIC and ICIVGTT (both P < 0.05) compared to T2D without (n=56). CON with steatosis (n=21) showed a trend towards impaired ICWBIC (P=0.059) than those without (n=94). ICMMT positively correlated with M-value (r=0.289 and r=0.272, both P < 0.05) in T1D and T2D, but not in CON.

Conclusion: Glycemic control impairs insulin clearance in T1D patients, whereas steatosis reduces clearance in T2D suggesting different compensatory mechanisms of insulin kinetics.

Volume 67

7th ESE Young Endocrinologists and Scientists (EYES) Meeting

European Society of Endocrinology 

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