Accuracy of the 13C-glucose breath test to identify insulin resistance in non-diabetic adults

Jorge Maldonado-Hernández, Azucena Martínez-Basila, Mario Enrique Rendón-Macías, Mardia Guadalupe Lopez Alarcon

Resultado de la investigación: Contribución a una revistaArtículo

Resumen

Aims: To assess the validity of the 13C-glucose breath test (13C-GBT) to identify insulin resistance (IR) in non-diabetic individuals, using hyperinsulinemic–euglycemic clamps as gold standard. This validity was compared with that of other IR surrogates. Methodology: Non-diabetic adults were studied in a cross-sectional design. In a first appointment, oral glucose tolerance tests were conducted simultaneously with 13C-GBTs. Oral 75 g glucose dissolved in 150 ml water, followed by 1.5 mg/Kg body weight U-13C-glucose dissolved in 50 ml water, was administered. Breath and blood samples were collected at baseline and at 30-min intervals. The percentages of glucose-oxidized dose at given periods were calculated. Clamps were conducted a week later. A clamp-derived M value ≤ 6.0 mg/kg*min was used as cut-off. ROC curves were constructed for 13C-GBT, fasting insulin, HOMA, and ISI-composite. Results: Thirty-eight subjects completed the study protocol. The correlation coefficient between the 13C-GBT derived glucose-oxidized dose at 180 min and M values was 0.524 (p = 0.001). The optimal value to identify IR with the 13C-GBT was 4.23% (AUC 0.81; 95CI 0.66, 0.96; accuracy 0.82, 95CI 0.66, 0.92). The 13C-GBT sensitivity (0.88) was higher than HOMA and fasting insulin sensitivities (0.83 and 0.75 respectively), while their specificities were comparable (0.71, 0.71, and 0.79, respectively). The sensitivity of ISI-C was higher (0.92) than that of the 13C-GBT, but its specificity was poor (0.36). The accuracy of the 13C-GBT was superior to that of the other studied surrogates. Conclusions: The 13C-GBT is a valid and accurate method to detect IR in non-diabetic adults. Therefore, it is potentially useful in clinical and community settings.

Idioma originalInglés
Páginas (desde-hasta)923-929
Número de páginas7
PublicaciónActa Diabetologica
Volumen56
N.º8
DOI
EstadoPublicada - 1 ago 2019

Huella dactilar

Breath Tests
Insulin Resistance
Glucose
Fasting
Water
Glucose Tolerance Test
ROC Curve
Area Under Curve
Appointments and Schedules
Body Weight

Citar esto

Maldonado-Hernández, Jorge ; Martínez-Basila, Azucena ; Rendón-Macías, Mario Enrique ; Lopez Alarcon, Mardia Guadalupe. / Accuracy of the 13C-glucose breath test to identify insulin resistance in non-diabetic adults. En: Acta Diabetologica. 2019 ; Vol. 56, N.º 8. pp. 923-929.
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title = "Accuracy of the 13C-glucose breath test to identify insulin resistance in non-diabetic adults",
abstract = "Aims: To assess the validity of the 13C-glucose breath test (13C-GBT) to identify insulin resistance (IR) in non-diabetic individuals, using hyperinsulinemic–euglycemic clamps as gold standard. This validity was compared with that of other IR surrogates. Methodology: Non-diabetic adults were studied in a cross-sectional design. In a first appointment, oral glucose tolerance tests were conducted simultaneously with 13C-GBTs. Oral 75 g glucose dissolved in 150 ml water, followed by 1.5 mg/Kg body weight U-13C-glucose dissolved in 50 ml water, was administered. Breath and blood samples were collected at baseline and at 30-min intervals. The percentages of glucose-oxidized dose at given periods were calculated. Clamps were conducted a week later. A clamp-derived M value ≤ 6.0 mg/kg*min was used as cut-off. ROC curves were constructed for 13C-GBT, fasting insulin, HOMA, and ISI-composite. Results: Thirty-eight subjects completed the study protocol. The correlation coefficient between the 13C-GBT derived glucose-oxidized dose at 180 min and M values was 0.524 (p = 0.001). The optimal value to identify IR with the 13C-GBT was 4.23{\%} (AUC 0.81; 95CI 0.66, 0.96; accuracy 0.82, 95CI 0.66, 0.92). The 13C-GBT sensitivity (0.88) was higher than HOMA and fasting insulin sensitivities (0.83 and 0.75 respectively), while their specificities were comparable (0.71, 0.71, and 0.79, respectively). The sensitivity of ISI-C was higher (0.92) than that of the 13C-GBT, but its specificity was poor (0.36). The accuracy of the 13C-GBT was superior to that of the other studied surrogates. Conclusions: The 13C-GBT is a valid and accurate method to detect IR in non-diabetic adults. Therefore, it is potentially useful in clinical and community settings.",
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Accuracy of the 13C-glucose breath test to identify insulin resistance in non-diabetic adults. / Maldonado-Hernández, Jorge; Martínez-Basila, Azucena; Rendón-Macías, Mario Enrique; Lopez Alarcon, Mardia Guadalupe.

En: Acta Diabetologica, Vol. 56, N.º 8, 01.08.2019, p. 923-929.

Resultado de la investigación: Contribución a una revistaArtículo

TY - JOUR

T1 - Accuracy of the 13C-glucose breath test to identify insulin resistance in non-diabetic adults

AU - Maldonado-Hernández, Jorge

AU - Martínez-Basila, Azucena

AU - Rendón-Macías, Mario Enrique

AU - Lopez Alarcon, Mardia Guadalupe

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Aims: To assess the validity of the 13C-glucose breath test (13C-GBT) to identify insulin resistance (IR) in non-diabetic individuals, using hyperinsulinemic–euglycemic clamps as gold standard. This validity was compared with that of other IR surrogates. Methodology: Non-diabetic adults were studied in a cross-sectional design. In a first appointment, oral glucose tolerance tests were conducted simultaneously with 13C-GBTs. Oral 75 g glucose dissolved in 150 ml water, followed by 1.5 mg/Kg body weight U-13C-glucose dissolved in 50 ml water, was administered. Breath and blood samples were collected at baseline and at 30-min intervals. The percentages of glucose-oxidized dose at given periods were calculated. Clamps were conducted a week later. A clamp-derived M value ≤ 6.0 mg/kg*min was used as cut-off. ROC curves were constructed for 13C-GBT, fasting insulin, HOMA, and ISI-composite. Results: Thirty-eight subjects completed the study protocol. The correlation coefficient between the 13C-GBT derived glucose-oxidized dose at 180 min and M values was 0.524 (p = 0.001). The optimal value to identify IR with the 13C-GBT was 4.23% (AUC 0.81; 95CI 0.66, 0.96; accuracy 0.82, 95CI 0.66, 0.92). The 13C-GBT sensitivity (0.88) was higher than HOMA and fasting insulin sensitivities (0.83 and 0.75 respectively), while their specificities were comparable (0.71, 0.71, and 0.79, respectively). The sensitivity of ISI-C was higher (0.92) than that of the 13C-GBT, but its specificity was poor (0.36). The accuracy of the 13C-GBT was superior to that of the other studied surrogates. Conclusions: The 13C-GBT is a valid and accurate method to detect IR in non-diabetic adults. Therefore, it is potentially useful in clinical and community settings.

AB - Aims: To assess the validity of the 13C-glucose breath test (13C-GBT) to identify insulin resistance (IR) in non-diabetic individuals, using hyperinsulinemic–euglycemic clamps as gold standard. This validity was compared with that of other IR surrogates. Methodology: Non-diabetic adults were studied in a cross-sectional design. In a first appointment, oral glucose tolerance tests were conducted simultaneously with 13C-GBTs. Oral 75 g glucose dissolved in 150 ml water, followed by 1.5 mg/Kg body weight U-13C-glucose dissolved in 50 ml water, was administered. Breath and blood samples were collected at baseline and at 30-min intervals. The percentages of glucose-oxidized dose at given periods were calculated. Clamps were conducted a week later. A clamp-derived M value ≤ 6.0 mg/kg*min was used as cut-off. ROC curves were constructed for 13C-GBT, fasting insulin, HOMA, and ISI-composite. Results: Thirty-eight subjects completed the study protocol. The correlation coefficient between the 13C-GBT derived glucose-oxidized dose at 180 min and M values was 0.524 (p = 0.001). The optimal value to identify IR with the 13C-GBT was 4.23% (AUC 0.81; 95CI 0.66, 0.96; accuracy 0.82, 95CI 0.66, 0.92). The 13C-GBT sensitivity (0.88) was higher than HOMA and fasting insulin sensitivities (0.83 and 0.75 respectively), while their specificities were comparable (0.71, 0.71, and 0.79, respectively). The sensitivity of ISI-C was higher (0.92) than that of the 13C-GBT, but its specificity was poor (0.36). The accuracy of the 13C-GBT was superior to that of the other studied surrogates. Conclusions: The 13C-GBT is a valid and accurate method to detect IR in non-diabetic adults. Therefore, it is potentially useful in clinical and community settings.

KW - Accuracy

KW - C-glucose breath test

KW - Hyperinsulinemic–euglycemic clamp

KW - ISI-composite

KW - Insulin resistance

KW - ROC curve

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U2 - 10.1007/s00592-019-01318-5

DO - 10.1007/s00592-019-01318-5

M3 - Artículo

AN - SCOPUS:85064205487

VL - 56

SP - 923

EP - 929

JO - Acta Diabetologica

JF - Acta Diabetologica

SN - 0940-5429

IS - 8

ER -