American Diabetes Association
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Lower hepatic fat is associated with improved insulin secretion in a high-risk prediabetes subphenotype during lifestyle intervention

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posted on 2022-12-16, 18:53 authored by Robert Wagner, Martin Heni, Konstantinos Kantartzis, Arvid Sandforth, Jurgen Machann, Fritz Schick, Andreas Peter, Louise Fritsche, Julia Szendrodi, Andreas FH Pfeiffer, Annette Schurmann, Matthias Bluher, Hans Hauner, Johchen Seissler, Stefan Bornstein, Michael Roden, Norbert Stefan, Andreas L Birkenfeld, Morris F. White, Hans-Ulrich Haring, Andreas Fritsche

The objective of this work was to investigate whether impaired insulin secretion can be restored by lifestyle intervention in specific subphenotypes of prediabetes.

One thousand forty-five participants from the Prediabetes Lifestyle Intervention Study (PLIS) were assigned to 6 recently established prediabetes clusters. Insulin secretion was assessed by a C-peptide-based index derived from oral glucose tolerance tests and modeled from three time-points during a 1-yr intervention. We also analyzed the change of glycemia, insulin sensitivity and liver fat.

All pre-diabetes high-risk clusters (cluster 3, 5 and 6) had improved glycemic traits during lifestyle intervention, whereas insulin secretion only increased in clusters 3 and 5 (p<0.001); however, high liver fat in cluster 5 was associated with a failure to improve insulin secretion (pinteraction<0.001). Thus, interventions to reduce liver fat have the potential to improve insulin secretion in a defined subgroup of prediabetes.  


The study was supported by the DZD. The DZD is funded by the German Federal Ministry for Education and Research and the states where its partner institutions are located (01GI0925).