Abstract P069: Longitudinal Associations Between Metabolic Status, Insulin Clearance, and Insulin Sensitivity: The Prospective Metabolism and Islet Cell Evaluation (PROMISE) Cohort
Bibliographic record
Abstract
Metabolically healthy obese individuals (MHO) are those with obesity but normal metabolic profiles. The relationship of MHO to type 2 diabetes mellitus (T2DM) risk is unclear. Limited data are available on metabolic status and declining insulin clearance (IC) and insulin sensitivity (IS), which are well-documented features in the pathogenesis of T2DM. Objective: To assess longitudinal changes in IC and IS among metabolically healthy and unhealthy obese and non-obese participants. Hypothesis: Longitudinal declines in IC and IS will be greater among participants classified as metabolically unhealthy and/or obese compared to metabolically healthy non-obese (MHN). Methods: Adults ≥30 years old at-risk for T2DM in PROMISE had three assessments over 6 years (n=558). Obesity was classified as BMI ≥30 kg/m 2 . Baseline metabolic parameters, including blood pressure, TAG, HDL, fasting glucose, waist circumference, and medication use, were used to determine metabolic status. Metabolically healthy status was defined as the presence of <3 metabolic abnormalities. Values from oral glucose tolerance tests at each visit were used to calculate Matsuda insulin sensitivity index (ISI), and the ratios of fasting C-peptide-to-insulin (IC FASTING ) and areas-under-the-curve of C-peptide-to-insulin (IC AUC ). Generalized estimating equations (GEE) evaluated the association of baseline metabolic status with longitudinal changes in IC and IS, adjusting for covariates. Results: The multivariate GEE model showed that MHO and MUO had greater declines in IC and IS over time compared to MHN ( Figure , both p<0.01). Metabolically unhealthy non-obese (MUN) had a longitudinal decline in IC FASTING but not IC AUC compared to MHN, and a more modest relative decline in IS. Conclusions: Compared to MHN, presence of a metabolically unhealthy and/or obese phenotype negatively impacted IC and IS over time. The more pronounced declines in IC in MUO and MHO may reflect a compensatory response to the poorer IS in these groups.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".