Adequately adapted insulin secretion and decreased hepatic insulin extraction cause elevated insulin concentrations in insulin resistant non-diabetic adrenal incidentaloma patients

Insulin-resistance is commonly found in adrenal incidentaloma (AI) patients. However, little is known about beta-cell secretion in AI, because comparisons are difficult, since beta-cell-function varies with altered insulin-sensitivity. To retrospectively analyze beta-cell function in non-diabetic AI...

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Bibliographic Details
Published in:PloS one 2013-10, Vol.8 (10), p.e77326-e77326
Main Authors: Anderwald, Christian-Heinz, Tura, Andrea, Gessl, Alois, Luger, Anton, Pacini, Giovanni, Krebs, Michael
Format: Article
Language:English
Subjects:
Adaptation
Adrenal Gland Neoplasms - metabolism
Anthropometry
Beta cells
Blood Glucose
Body measurements
C-Peptide - blood
Case-Control Studies
Comparative analysis
Control methods
Cortisol
Dexamethasone
Diabetes mellitus
Female
Glucose
Glucose tolerance
Glucose Tolerance Test
Humans
Insulin
Insulin - blood
Insulin - metabolism
Insulin Resistance
Insulin Secretion
Insulin-Secreting Cells - metabolism
Liver
Liver - metabolism
Male
Males
Mathematical analysis
Mathematical models
Middle Aged
Patients
Peptides
Retrospective Studies
Risk Factors
Rodents
Secretion
Sensitivity
Sensitivity analysis
Studies
Subgroups
Type 2 diabetes
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Summary:Insulin-resistance is commonly found in adrenal incidentaloma (AI) patients. However, little is known about beta-cell secretion in AI, because comparisons are difficult, since beta-cell-function varies with altered insulin-sensitivity. To retrospectively analyze beta-cell function in non-diabetic AI, compared to healthy controls (CON). AI (n=217, 34%males, 57 ± 1 years, body-mass-index:27.7 ± 0.3 kg/m(2)) and CON [n = 25, 32%males, 56 ± 1 years, 26.7 ± 0.8 kg/m(2)] with comparable anthropometry (p ≥ 0.31) underwent oral-glucose-tolerance-tests (OGTTs) with glucose, insulin, and C-peptide measurements. 1mg-dexamethasone-suppression-tests were performed in AI. AI were divided according to post-dexamethasone-suppression-test cortisol-thresholds of 1.8 and 5 µg/dL into 3 subgroups: pDexa5 µg/dL. Using mathematical modeling, whole-body insulin-sensitivity [Clamp-like-Index (CLIX)], insulinogenic Index, Disposition Index, Adaptation Index, and hepatic insulin extraction were calculated. CLIX was lower in AI combined (4.9 ± 0.2 mg · kg(-1) · min(-1)), pDexa
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0077326