Oral Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2023

Hyperinsulinemia and prediabetes in young, non-obese individuals (98167)

Vicky Kuriel 1 , Greg Kowalski 2 , Andrew Betik 3 , Clinton Bruce 1 , Christopher Shaw 1
  1. Faculty of Health, School of Exercise and Nutrition Science (IPAN), Deakin University, Geelong, Victoria, Australia
  2. Faculty of Medicine, Deakin University, Geelong, Victoria, Australia
  3. Faculty of Health, School of Exercise and Nutrition Science (IPAN), Deakin University, Burwood, Victoria, Australia

High fasting insulin concentration (hyperinsulinemia (HI)) is considered as a compensatory response which enables the maintenance of blood glucose concentrations in the presence of tissue insulin resistance. Obesity is thought to be a key driver for HI, prediabetes and overt diabetes. However, the United Kingdom Prospective Diabetes Study (1) showed a third of patients with type 2 diabetes had a BMI within the healthy weight range (<25g/m2), suggesting that factors other than obesity are important. We aimed to assess the metabolic health of non-obese apparently healthy young adults to inform on the factors driving HI and prediabetes. To date, we have screened 361 individuals (204 females; 157 males, age: 24.8 ± 4.4 y, BMI: 23.7 ± 3.0 kg/m2) via oral glucose tolerance test with plasma insulin, fasting blood lipids, blood pressure, body composition and dietary intake. 11% (n=40) were found to have prediabetes (Impaired Fasting Glucose (n=24) and/or Impaired Glucose Tolerant (n=26)). Normal glucose tolerant individuals (n=321) were classified as either having normal fasting insulin (n=274) (Females ≤40.47 pM; Males ≤56.82 pM) or fasting HI (n=47). Whilst BMI was largely considered to be within a normal range within the HI group (25.0 ± 3.3 kg/m2), there was a significantly higher body fat percentage in both the HI and prediabetic group as compared to the normal group (P < 0.05). Similarly, fasting triglyceride was significantly elevated in the HI group compared to the normal group (P < 0.05). These data highlight the high prevalence of prediabetes in non-obese young adults. Furthermore, fasting HI is present despite similar BMI and blood glucose concentrations to the normal insulin group. Overall, obesity-independent factors should be considered when examining the mechanisms driving adverse metabolic health outcomes in young adults.

 

 

 

 

 

 

  1. 1. Taylor R, Holman RR. Normal weight individuals who develop type 2 diabetes: the personal fat threshold. Clin Sci (Lond). 2015;128(7):405-410. doi:10.1042/CS20140553