Hepatic Glucose Uptake During Euglycemic Hyperinsulinemia Associates With Glycemia During Oral Glucose Tolerance Test
Bibliographic record
Abstract
Abstract Context Postprandial hepatic glycogen synthesis and glycolysis are reduced in hepatic insulin resistance. However, the physiologic interpretation of the reduction in hepatic glucose uptake (GU) during the gold-standard measurement of insulin sensitivity, hyperinsulinemic euglycemic clamp, in insulin resistance is unclear. This is because the peripheral route of glucose and insulin delivery during a clamp study differs greatly from the physiological route. Objective We hypothesized that hepatic GU during hyperinsulinemic euglycemic clamp would predict glycemia during oral glucose tolerance test (OGTT). Design We analyzed cross-sectional data of 120 individuals (70 men and 50 women) who did not have diabetes from the CMgene study cohort. Hepatic GU was measured with [18F]fluorodeoxyglucose ([18F]FDG) and positron emission tomography. Results In a multiple regression analysis, hepatic GU, endogenous glucose production, insulin secretion capacity, and serum triglycerides predicted OGTT glucose area under the curve (P for all <.05), whereas skeletal muscle GU, the antilipolytic insulin index, and insulin clearance were not statistically significant predictors (P > .05). Conclusions Hepatic GU measured during hyperinsulinemic euglycemic clamp is an independent predictor of OGTT glucose area under the curves even when accounting for well-known other factors affecting glycemic control. This finding supports the idea that insulin-mediated hepatic GU, and more broadly, first-pass glucose extraction, have a meaningful contribution to glycemic control. Thus, this measurement provides useful information about hepatic insulin sensitivity in the more physiologic conditions of the OGTT which may be useful when studying the pathophysiology of impaired glucose tolerance and when evaluating potential treatments for impaired glycemic control.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".