Reproducibility and determinants of the metabolic responses during a mixed‐meal tolerance test
Authors' conclusion
Reproducibility of glucose/insulin responses to MMTTs varied by subtraction of fasting values, glucose status, and time. Insulin secretion and action explained ~20% of MMTT responses. The substantial variability in MMTT response requires consideration in studies using MMTT outcomes.
Study context
- Population
- Inpatients on a weight-maintaining diet undergoing 9-hour mixed-meal tolerance tests (breakfast and lunch; 40% carbohydrate, 40% fat, 20% protein)
- Participants
- 894 inpatients
- Exposure
- Normal glucose regulation vs Impaired glucose regulation vs T2D
- Normal glucose regulationn = 574
- Impaired glucose regulationn = 267
- T2Dn = 53
- Outcome
- Reproducibility (ICC) of glucose and insulin AUC/iAUC during MMTTs, and their physiological determinants (AIR, insulin action M)
Methodological detailsreproducibility and determinants analysis, inpatient, weight-maintaining diet, repeat mixed-meal tolerance tests (MMTTs) in a subset
- Reproducibility and determinants analysis
- Inpatient
- Weight-maintaining diet
- Repeat MMTTs in a subset
Main finding
As reported in the abstract
Reproducibility of MMTT glucose/insulin responses (ICC)
- Without T2D, glucose AUC, breakfast vs lunch: moderate (ICCs)
- 0.44-0.61
- Without T2D, glucose iAUC, breakfast vs lunch: poor (ICCs)
- < 0.15
- Without T2D, glucose AUC/iAUC, repeated MMTTs: low (ICCs)
- 0.11-0.36
- Without T2D, insulin AUC, breakfast vs lunch: high (ICCs)
- > 0.70
- Without T2D, insulin iAUC, breakfast vs lunch: moderate (ICCs)
- 0.64-0.71
- Without T2D, insulin AUC/iAUC, repeated MMTTs (ICC)
- 0.34 to 0.54
- T2D, glucose AUC (ICC)
- >0.80
- T2D, glucose iAUC (ICC)
- >0.50
- T2D, insulin AUC/iAUC (ICC)
- <0.40
Observational data: associations, not effects.
Further findings
Determinants: association of MMTT AUCs with insulin action (M) and acute insulin response (AIR)
- Glucose AUCs associated with M/AIR (partial Rs)
- < −0.25
- Insulin AUCs negatively with M / positively with AIR (partial Rs)
- −0.51/0.24
Original publication
Reproducibility and determinants of the metabolic responses during a mixed‐meal tolerance test. Obesity (Silver Spring). Published 14 February 2023. doi:10.
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