Effects of a new 75 g glucose- and high fat-containing cookie meal test on postprandial glucose and triglyceride excursions in morbidly obese patients

Abstract

A new meal tolerance test (MTT) using a 75 g glucose-and high fat-containing meal was applied to classify glucose intolerance in morbidly obese patients. According to the MTT data, the concordance rate of diagnosis was 82.5% compared to the 75 g oral glucose tolerance test (OGTT) in patients with normal glucose tolerance (NGT, n = 40). In the NGT patients, the insulinogenic index (r = 0.833), Matsuda index (r = 0.752), and disposition index (r = 0.845) calculated from the MTT data were each significantly (p < 0.001) correlated with those derived from the OGTT data. However, in patients with impaired glucose tolerance (IGT, n = 23) or diabetes mellitus (DM, n = 17), the postprandial glucose levels post-MTT were significantly lower than those post-OGTT, without increases in the postprandial insulin levels post-MTT. Thus, the severity of glucose intolerance measured by the MTT was milder than that indicated by the OGTT. Plasma levels of both glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) were increased at the postprandial state, but only the GIP levels post-MTT were significantly higher than those post-OGTT. The enhancement of glucose disposal rates in patients with NGT or IGT after the MTT was associated with increased GIP levels. The postprandial hypertriglyceridemia induced by the MTT was associated with insulin resistance, but it was not associated with the impaired insulinogenic index or the disposition index. These results indicate that the new MTT is clinically useful to evaluate both abnormal glucose and triglyceride excursions caused by abnormal insulin sensitivity and secretions of insulin and gut hormones in morbidly obese patients.

The oral disposition index calculated from a meal tolerance test is a crucial indicator for evaluating differential normalization of postprandial glucose and triglyceride excursions in morbidly obese patients after laparoscopic sleeve gastrectomy

“…In that investigation, the MTT was demonstrated to be useful for determining the precise staging of impaired glucose tolerance compared to the 75-g OGTT. We also observed that this MTT meal containing saturated fat can be used to evaluate postprandial hypertriglyceridemia in morbidly obese patients [10].…”

“…The 75-g OGTT and MTT protocols were as we described [10]. Briefly, on the 2nd day after their hospital admission, the patients underwent a 75-g OGTT.…”

“…The glucose tolerance, homeostatic model assessment of insulin resistance (HOMA-R), insulin secretion-beta (HOMA-β), insulinogenic index, and Matsuda index were calculated from the patients' OGTT and MTT data [10,30,31]. In the present study, we measured glucoseinduced insulin secretory (GIS) activities by using the following four parameters: the insulinogenic index (ΔINS 0-30 /ΔPG 0-30 ), the acute GIS (INS-AUC 0-30 /PG-AUC 0-30 ), the total GIS (INS-AUC 0-120 /PG-AUC 0-120 ), and theΔCPR 0-30 /ΔPG 0-30 .…”

“…Our research group have reported that compared to the 75-g OGTT, a new meal tolerance test (MTT) that uses a test meal containing wheat starch equivalent to 75 g glucose, 28.5 g of butter fat, and a low amount of protein is able to reduce postprandial hyperglycemia with a lower postprandial secretion of insulin in morbidly obese individuals with or without glucose intolerance [10]. In that investigation, the MTT was demonstrated to be useful for determining the precise staging of impaired glucose tolerance compared to the 75-g OGTT.…”

A bibliometric analysis and visualization of literature on non-fasting lipid research from 2012 to 2022

“…The triglyceride-insulin-glucose-glucagon-like peptide-1 model was built to assess glucose, insulin, and incretin responses following a high-fat meal ( 49 ). The OFTT can help patients identify insulin sensitivity impairments, insulin resistance, beta-cell dysfunctions and secretion disorders of gut hormones, including glucose-dependent insulinotropic polypeptides and glucagon-like peptide-1 ( 21 , 50 ).…”