Glucose tolerance, plasma lipids and atherosclerosis.
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Biomedical subjects
Publications and source records attributed to H Keen.
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Diurnal variation in oral glucose tolerance was studied in 122 male volunteers aged 40 yearsand over who participated in a screening health examination. In those with screening blood sugar levels exceeding 110 mg./100 ml. the degree of diurnal variation was least in those with the highest morning glycaemia; the latter also tended to have lower afternoon fasting bloodsugar levels.In a group of 40 control subjects, afternoon glucose tolerance tests yielded significantly higher post-glucose blood sugar levels. The degree of diurnal variation was significantly and inversely related to the degree of obesity.
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Possible diurnal variation in the blood sugar response to oral glucose was studied by comparing, in the same individuals, the results of oral glucose tolerance tests performed in the morning and the afternoon. In a group of normal individuals the blood sugar levels were significantly higher in the afternoon. In hyperglycaemic individuals the diurnal variation decreased as the blood sugar levels reached during the morning test increased, so that in a group of grossly hyperglycaemic men the mean morning and afternoon tests were almost identical. The causes of this diurnal variation are not known.
Oral glucose tolerance tests were performed on 220 people, a representative sample of the employees of a large pharmaceutical company. Blood sugar and plasma immunoreactive insulin levels were measured on each sample of venous blood obtained before and at half-hourly intervals for two hours after 50 g. of glucose by mouth; plasma cholesterol and glycerides were measured on the fasting sample only.Women had higher mean insulin levels throughout the test, though their mean blood sugar levels were higher only at 90 and 120 minutes. In both sexes there were positive correlations between age and the levels of blood sugar, plasma cholesterol, and plasma glycerides. Though the levels of glucose rose with age, those of insulin did not.
The data available from the previous paper have been analysed to determine the interaction between the blood sugar and plasma insulin responses to oral glucose and a number of other biological variables. The total sugar and insulin responses were derived by calculating the total area and the incremental area under the curves.The blood sugar area was significantly correlated with age in both men and women, particularly the former. A striking degree of correlation was found in men between the level of fasting glycerides and the blood sugar area. There was a significant correlation also in women, but this was entirely due to the presence of the older, postmenopausal individuals. A lower degree of correlation was found in both sexes between fasting glycerides and the insulin area.Obesity, as defined by three interrelated factors-ponderal index, triceps fat-fold thickness, and arm girth -was significantly correlated with the insulin area (the association being stronger in the men) and with the blood sugar area only in men.The fasting cholesterol level was correlated with obesity in both sexes but with the blood sugar area and the insulin area only in men.
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