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Acta Diabetologica

, Volume 52, Issue 4, pp 817–819 | Cite as

Ethnic disparities in insulin and glucose-dependent insulinotropic peptide (GIP) responses to intraduodenal glucose in health

  • Chinmay S. MaratheEmail author
  • Michelle Bound
  • Kylie Lange
  • Karen L. Jones
  • Christopher K. Rayner
  • Michael Horowitz
Open Access
Letter to the Editor

Keywords

Insulin Sensitivity Insulin Secretion East Asian Population Incretin Hormone Impaired Insulin Secretion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

ID4

Intraduodenal glucose infusion at 4 kcal/min

GIP

Glucose-dependent insulinotropic polypeptide

GLP-1

Glucagon-like peptide-1

DI

Disposition index

HC

Han Chinese

C

Caucasian

East Asians appear to secrete less insulin than Caucasians following oral glucose suggesting that impaired insulin secretion is fundamental to the pathogenesis of type 2 diabetes [1]. Information about the secretion of the incretin hormones, GIP and GLP-1, dependent on duodenal glucose load [2], in East Asians is limited [3]. We have evaluated glycemic, insulinemic and incretin hormone responses to intraduodenal glucose in healthy Han Chinese.

We studied eleven Han Chinese (HC) and eight Caucasian (C) healthy men; the latter included in a previous study [2]. Each subject attended following an overnight fast. A catheter, incorporating an infusion channel opening 12 cm beyond the pylorus, was inserted intranasally [2]. An IV cannula was placed in an antecubital vein. Intraduodenal (ID) glucose (25 g/100 mL) was infused at 4 kcal/min from t = 0 to 120 min. Blood was collected at t = 0, 15, 30, 45, 60, 90, 105 and 120 min for measurements of blood glucose, plasma insulin, GIP and GLP-1. Insulin secretion was estimated as the change in insulin divided by the change in glucose at 30 min (∆I 0–30/∆G 0–30). Insulin sensitivity was estimated as 1/fasting insulin. The disposition index (DIO) was calculated as ∆I 0–30/∆G 0–30 X 1/fasting insulin. Unpaired Student’s t test was used in analysis.

Han Chinese younger than Caucasians (24.8 ± 1.3 HC vs. 45.3 ± 3.8 C years, P < 0.01); there was no difference in BMI (25.1 ± 1.7 HC vs. 28.3 ± 0.7 C kg/m2). There were no differences in fasting glucose (5.4 ± 0.1 HC vs. 5.7 ± 0.2 C, mmol/L, P = 0.10) or glycemic response to ID glucose. Fasting (4.9 ± 0.8 HC vs. 19.2 ± 3.9 C, mU/L, P < 0.01) and AUC0–120 (13,234 ± 2,134 HC vs. 43,133 ± 12,197 C, mU/L min, P = 0.01) insulin and insulin secretion (15.5 ± 5.2 HC vs. 63.2 ± 22 C, P = 0.02) were lower in Han Chinese. The DIO was not different (2.9 ± 0.4 HC vs. 3.5 ± 1.3 C, P = 0.63). Fasting (16.2 ± 1.3 HC vs. 22 ± 2.9 C, pmol/L, P = 0.06) and AUC0–120 (5,836 ± 337 HC vs. 7,975 ± 739 C, pmol/L min, P = 0.01) GIP were lower in Han Chinese. There was no difference in fasting (25 ± 3.3 HC vs. 19.8 ± 2.4 C, pmol/L, P = 0.24) or glucose-stimulated GLP-1 (Fig. 1).
Fig. 1

Blood glucose (a), plasma insulin (b), GIP (c) and GLP-1 (d) concentrations at baseline and in response to a 120-min intraduodenal glucose infusion at 4 kcal/min in Han Chinese (Filled circles with bold line) and Caucasian (Empty circles with dotted line) subjects. Data are mean ± SEM

Our study indicates that, in response to intraduodenal glucose infusion, insulin secretion is less and insulin sensitivity is greater in Han Chinese than in Caucasians, associated with reduced GIP, but comparable GLP-1, secretion and DIO—the latter reflecting increased insulin sensitivity in Han Chinese. Few studies have evaluated GIP and GLP-1 responses within East Asian populations. In the only direct comparison [3], healthy Japanese were reported to have higher GIP and lower GLP-1 than Caucasians, but methodological limitations preclude meaningful interpretation. The reduced GIP response we observed could contribute to the diminished insulin response. In type 2 diabetes, the insulinotropic capacity of GIP is markedly reduced, and the reduction in GIP is likely to be of primary relevance to ‘health.’

Limitations of our study are that the cohort was of small size and exclusively male, that responses to intraduodenal, rather than oral, glucose were evaluated and that there was a difference in age between the groups, although GIP (and GLP-1) response is apparently unaffected by age [4]. Mean BMI was higher in the Caucasians, albeit non-significantly, which may represent a confounder, although it appears that body weight does not affect the GIP response to nutrients [5].

Notes

Acknowledgments

The study was supported by a grant awarded by the National Health and Medical Research Council (NHMRC) of Australia. Professor Jones’ salary is provided by a NHMRC Senior Career Development Award Fellowship.

Conflict of interest

The authors declare they have no conflict of interest.

Ethical standard

The study protocol conformed to the principles of the Declaration of Helsinki, and was approved by the Royal Adelaide Hospital Research Ethics Committee.

Human and animal rights disclosure

All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 [5].

Informed consent disclosure

Informed consent was obtained from all patients for being included in the study.

References

  1. 1.
    Matsumoto K, Miyake S, Yano M, Ueki Y, Yamaguchi Y, Akazawa S et al (1997) Glucose tolerance, insulin secretion, and insulin sensitivity in nonobese and obese Japanese subjects. Diabetes Care 20(10):1562–1568PubMedCrossRefGoogle Scholar
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    Marathe CS, Rayner CK, Bound M, Checklin H, Standfield S, Wishart J et al (2014) Small intestinal glucose exposure determines the magnitude of the incretin effect in health and type 2 diabetes. DiabetesGoogle Scholar
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    Seino Y, Fukushima M, Yabe D (2010) GIP and GLP-1, the two incretin hormones: similarities and differences. J Diabetes Investig 1(1–2):8–23PubMedCentralPubMedCrossRefGoogle Scholar
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    Trahair LG, Horowitz M, Rayner CK, Gentilcore D, Lange K, Wishart JM et al (2012) Comparative effects of variations in duodenal glucose load on glycemic, insulinemic, and incretin responses in healthy young and older subjects. J Clin Endocrinol Metab 97(3):844–851PubMedCrossRefGoogle Scholar
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    Wu T, Ma J, Bound MJ, Checklin H, Deacon CF, Jones KL et al (2014) Effects of sitagliptin on glycemia, incretin hormones, and antropyloroduodenal motility in response to intraduodenal glucose infusion in healthy lean and obese humans and patients with type 2 diabetes treated with or without metformin. Diabetes 63(8):2776–2787PubMedCrossRefGoogle Scholar

Copyright information

© The Author(s) 2014

Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

Authors and Affiliations

  • Chinmay S. Marathe
    • 1
    • 2
    Email author
  • Michelle Bound
    • 1
    • 2
  • Kylie Lange
    • 1
    • 2
  • Karen L. Jones
    • 1
    • 2
  • Christopher K. Rayner
    • 1
    • 2
  • Michael Horowitz
    • 1
    • 2
  1. 1.Discipline of Medicine, Royal Adelaide HospitalUniversity of AdelaideAdelaideAustralia
  2. 2.Centre of Research Excellence (CRE) in Translating Nutritional Science to Good HealthUniversity of AdelaideAdelaideAustralia

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