What does this research mean for the field?

A mixed macronutrient tolerance test (MMTT) using three blood draws can simultaneously determine insulin sensitivity and postprandial triglyceridemia, yielding an insulin sensitivity index that strongly correlates (r = 0.77) with the standard oral glucose tolerance test-dependent Matsuda index. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to validate a mixed macronutrient tolerance test to assess insulin sensitivity and postprandial triglyceridemia.

May 11, 2022Frontiers in NutritionOpen Access

Assessing Insulin Sensitivity and Postprandial Triglyceridemic Response Phenotypes With a Mixed Macronutrient Tolerance Test

Q: What are the key findings of this study?

The mixed macronutrient tolerance test insulin sensitivity index was strongly correlated (r = 0.77) with the oral glucose tolerance test-dependent 2-hour composite Matsuda index.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Healthy, overweight, and obese individuals without clinically diagnosed disease (n=383). Intervention: Mixed macronutrient tolerance test (MMTT) vs. Oral glucose tolerance test (OGTT). Primary outcome: Correlation between MMTT insulin sensitivity index (ISIMMTT) and OGTT-dependent 2-hour composite Matsuda index (ISIComposite) (r = 0.77, p=<0.001).

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Key result

MMTT insulin sensitivity index shows a strong 0.77 correlation with the OGTT Matsuda index.

r = 0.77
P<0.001
n=383

Why the study?

Challenge meal compositions and protocols for assessing postprandial carbohydrate and fat metabolism remain variable.

Does a mixed macronutrient tolerance test accurately assess insulin sensitivity and postprandial triglyceridemia in healthy and overweight individuals?

Population

43 overweight/obese women and 340 men and women aged 18-64 with BMI 18-40 kg/m 2

Comparison

MMTT vs OGTT and fasting indications

Design

Validation study across two cohorts

Authors

JNJohn W. NewmanWestern Human Nutrition Research Center SKSridevi KrishnanUniversity of Arizona KBKamil BorkowskiUniversity of California, Davis

Discussion

Member takes

Implication

May support simplified mixed macronutrient testing for concurrent insulin sensitivity and triglyceride assessment; hypothesis-generating and requires prospective validation.

Key Points

This research aims to validate a mixed macronutrient tolerance test to assess insulin sensitivity and postprandial triglyceridemia.
Two study populations: one with women with overweight/obese BMIs (n=43) and another with 340 subjects (18-64 years),
MMTT administered with mixed nutrients; blood collected at 0, 0.5, 3, and 6 hours for metabolic assessment.
Insulin sensitivity measured using the Matsuda Index algorithm based on glucose and insulin levels.
ISI MMTT showed a strong correlation with the 2 h composite Matsuda index (r=0.77, p<0.001).
Mild-to-moderate triglyceridemia established with an area under triglyceride excursion curve >11.15 mg/mL h-1, a ∼20% higher prevalence than fasting states.
Postprandial response patterns stratified using the triglyceride rate of change, with ∼25% of subjects showing increasing triglyceride levels through 6 hours.

Study Design

Type

Observational (n=383)

Multicenter

Structured PICO

Does a mixed macronutrient tolerance test accurately assess insulin sensitivity and postprandial triglyceridemia in healthy and overweight individuals?

Population

383 individuals from two cohorts: 43 women with overweight/obese BMIs (iMAPS study) and 340 men and women aged 18-64 with BMI 18-40 kg/m2 (Phenotyping study).

Intervention

Mixed macronutrient tolerance test (MMTT) containing 56-g palm oil, 59-g sucrose, and 26-g egg white protein.

Comparator

Oral glucose tolerance test (OGTT) and fasting triglyceride levels.

Outcome

Correlation of MMTT insulin sensitivity index (ISI MMTT) with OGTT-dependent 2 h composite Matsuda index, and assessment of postprandial triglyceridemia.surrogate

Main Result

Effect estimate: r = 0.77

p-value: p=<0.001

A mixed macronutrient tolerance test using three blood draws can simultaneously and accurately determine insulin sensitivity and postprandial triglyceridemia.

Limitations

A 2-hour blood draw was not performed during the MMTT, making the 3-hour blood draw a compromise.
Failure to obtain a return to baseline triglyceride levels for most participants prevents a true assessment of meal triglyceride absorption and elimination rates.

Cite This Study

Newman et al. (2022) conducted an observational in Healthy, overweight, and obese individuals without clinically diagnosed disease (n=383). Mixed macronutrient tolerance test (MMTT) vs. Oral glucose tolerance test (OGTT) was evaluated on Correlation between MMTT insulin sensitivity index (ISIMMTT) and OGTT-dependent 2-hour composite Matsuda index (ISIComposite) (r = 0.77, p=<0.001). The mixed macronutrient tolerance test insulin sensitivity index was strongly correlated (r = 0.77) with the oral glucose tolerance test-dependent 2-hour composite Matsuda index.

synapsesocial.com/papers/6a172e3be6fc0256052c270d https://doi.org/10.3389/fnut.2022.877696

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Implication

May support simplified mixed macronutrient testing for concurrent insulin sensitivity and triglyceride assessment; hypothesis-generating and requires prospective validation.

Assessing Insulin Sensitivity and Postprandial Triglyceridemic Response Phenotypes With a Mixed Macronutrient Tolerance Test

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Assessing Insulin Sensitivity and Postprandial Triglyceridemic Response Phenotypes With a Mixed Macronutrient Tolerance Test

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider