AJP - Endocrinology and Metabolism, Vol 272, Issue 2 E218-E226, Copyright © 1997 by American Physiological Society

ARTICLES

Disorderly and nonstationary insulin secretion in relatives of patients with NIDDM

O. Schmitz, N. Porksen, B. Nyholm, C. Skjaerbaek, P. C. Butler, J. D. Veldhuis and S. M. Pincus
Department of Medicine M (Endocrinology and Diabetes), University Hospital of Aarhus, Denmark.

To further explore the role of the beta-cell as a pathogenic factor behind non-insulin-dependent diabetes mellitus (NIDDM), insulin secretion at modest hyperglycemia was examined in 15 healthy first-degree relatives of NIDDM patients and 13 anthropometrically and age-matched controls. The oral glucose tolerance test was normal in all, but the relatives had impaired insulin-stimulated glucose uptake (P < 0.05). During a constant intravenous glucose infusion we performed a time-series analysis of serum insulin in samples obtained at 1-min intervals for 75 min (60-135 min). The recently introduced scale- and model-independent statistic approximate entropy (ApEn) and the coefficient of variation for a 6- (9 and 15) point moving average (MA) were applied to test regularity and stationarity, respectively, of insulin secretion. Both ApEn and 6-point MA were able to significantly discern the insulin time series of the two groups (P < 0.05), demonstrating a higher degree of irregularity and nonstationarity among the offspring. Moreover, when the two complementary sets of statistics were combined into a single "index of nonpulsatility," an even more notable distinction was available (P < 0.01). No relationship was found between altered insulin secretion and insulin resistance. In conclusion, this experimental and statistical model demonstrates that the stimulated insulin secretion of glucose-tolerant relatives of NIDDM patients is characterized by disorderliness. Whether the model can predict the risk for developing a clinically important beta-cell dysfunction remains to be clarified.

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