Impaired glucose tolerance in healthy men with low body weight

Abstract

BackgroundImpaired glucose tolerance (IGT) and high body mass index (BMI) are recognized risk factors for type 2 diabetes mellitus (T2DM). However, data suggest that also underweight predisposes people to develop T2DM. Here, we experimentally tested if already moderate underweight is associated with impaired glucose tolerance as compared to normal weight controls. Obese subjects were included as additional reference group.MethodWe included three groups of low weight, normal weight, and obese subjects comprising 15 healthy male participants each. All participants underwent a standardized hyperinsulinemic-euglycemic glucose clamp intervention to determine glucose tolerance. In addition, insulin sensitivity index (ISI) was calculated by established equation.ResultsISI values were higher in low and normal weight than in obese subjects (P < 0.010) without any difference between low and normal weight groups (P = 0.303). Comparable to obese participants (P = 0.178), glucose tolerance was found decreased in low weight as compared with normal weight subjects (P = 0.007). Pearson's correlation analysis revealed a positive relationship between glucose tolerance and BMI in low (P = 0.043) and normal weight subjects (P = 0.021), an effect that was found inverse in obese participants (P = 0.028).ConclusionOur study demonstrates that not only obese but also healthy people with moderate underweight display glucose intolerance. It is therefore suggested that all deviations from normal BMI may be accompanied by an increased risk of developing T2DM in later life indicating that the maintenance of body weight within the normal range has first priority in the prevention of this disease.

Global variability in diabetes mellitus and its association with body weight and primary healthcare support in 49 low‐ and middle‐income developing countries

“…The present study also observes that underweight participants had higher odds of having diabetes as compared with those with normal weight. This finding is consistent with results from previous reports [17,18]. Biologic mechanisms behind the association between underweight and diabetes are uncertain.…”

Germ-Free Swiss Webster Mice on a High-Fat Diet Develop Obesity, Hyperglycemia, and Dyslipidemia

“…The fasting levels of insulin we observed were highest in CV mice on the HFD, but these were also high in half of the GF mice on the HFD and half of the CV mice on the LFD. The inability of our mice to maintain their circulating concentrations of glucose and insulin within a healthy range is a critical step in the pathway from obesity to chronic diseases; however, impaired glucose metabolism can develop in the absence of obesity [77]. A HFD diet can promote elevated glucose concentrations in circulation because the glycerol unit of TAG can be converted to glucose [78].…”

Risk equations for the development of worsened glucose status and type 2 diabetes mellitus in a Swedish intervention program

“…All are well-known risk factors for the development of T2D. In a study by Jauch-Chara and colleagues, low body weight was associated with increased risk to develop IGT from NGT [ 31 ]. Underweight could not be examined separately in our study but was combined with normal weight due to the low number of cases in the underweight category.…”