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Serum -hydroxybutyrate (-HB) is elevated in insulin resistance and diabetes. We tested the hypothesis that the -HB level predicts abnormal 1h glucose levels and -cell dysfunction inferred from plasma insulin kinetics during a 75g oral glucose tolerance test (OGTT).', 'This cross-sectional study included 217 patients at increased risk for diabetes. 75g OGTTs were performed with multiple postload glucose and insulin measurements over a 30-120min period. OGTT responses were analyzed by repeated measures analysis of variance (ANOVA). Multivariable logistic regression was used to predict 1h glucose 155mg/dL with -HB added to traditional risk factors.', 'MeanSD age was 5115years (44% male, 25% with impaired glucose tolerance). Fasting glucose and insulin levels, but not age or body mass index (BMI), were significantly higher in the second/third -HB tertiles (>3.9g/mL) than in the first tertile. Patients in the second/third -HB tertiles exhibited a higher glucose area under the receiver operating characteristics curve (AUC) and reduced initial slope of insulin response during OGTT. The AUC for predicting 1h glucose 155mg/dL was 0.82 for a base model that included age, gender, BMI, fasting glucose, glycated hemoglobin (HbA1c), and insulin, and increased to 0.86 with -HB added (p=0.015), with a net reclassification index of 52% (p<0.0001).
Does serum -hydroxybutyrate ( -HB ) predict elevated 1 h glucose levels and early-phase -cell dysfunction during OGTT?