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Cited by 340Diabetes, Cardiovascular Risks, and LipoproteinsPancreatic function and diabetesAdipokines, Inflammation, and Metabolic Diseases

Insulin action and age. European Group for the Study of Insulin Resistance (EGIR)

Ferrannini, E., Vichi, S., Beck-Nielsen, H., Laakso, M., Paolisso, G., Smith, U.·1996·Diabetes
DOI 10.2337/diabetes.45.7.947
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Abstract

Evidence that age is associated with insulin resistance is discordant. We analyzed euglycemic insulin clamp (1 mU x min(-1) x kg(-1)) data collected at 20 centers throughout Europe from 1,146 men and women with normal glucose tolerance, ranging in age from 18 to 85 years. In the whole group, insulin action (as the M value) declined slightly with age (at a rate of 0.9 micromol x min(-1)-kg(-1) per decade of life, 95% CI = 0.4-1.3, P = 0.0002). When adjusted for BMI, this relationship was no longer statistically significant. The same result was obtained whether insulin action was expressed per kilogram of body weight or per kilogram of fat-free mass, expressed as the M:I ratio, or estimated from fasting plasma insulin concentrations. Subgroup analysis showed that a significant BMI-adjusted decrease in insulin action with age was present only in lean (BMI <25 kg/m2) women (a rate of 1.6 micromol x min(-1) x kg(-1) per decade, 95% CI = 0.6-2.5, P = 0.001), in whom percentage fat mass also increased with age (by 0.38% body weight per decade, P = 0.0007). Insulin action was positively associated with insulin suppression of circulating free fatty acids (FFAs) (+1.5 micromol x min(-1) x kg(-1) for each 10% increase in FFA suppression, P < 0.0001) in a multivariate model accounting for sex, BMI, age, and fasting FFA levels. Furthermore, insulin suppression of FFAs improved with age in men (2% per decade, P < 0.0001) but not in women. In the subgroup of lean women in whom insulin action declined with age, adding FFA suppression to a multiple regression equation canceled the association between age and insulin action. Thus, the small effect of age on insulin action could be adequately explained on the basis of age-related changes in body composition and substrate competition. We conclude that in healthy Europeans, age per se is not a significant cause of insulin resistance of glucose metabolism or lipolysis.

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  • The effect of aerobic (endurance) training on insulin sensitivity in the elderly population is uncertain, with some reporting a clear benefit and others no effect.

    “In contrast, the effect of aerobic (endurance) training on insulin sensitivity in the elderly population is uncertain, with some reporting a clear benefit (36,37) and others no effect, despite increased muscle GLUT4 and mitochondrial oxidative capacity (38).”

    From ]. The Influence of Age on the Effects of Lifestyle Modification and Metformin in Prevention of Diabetes (2006) · cites this paper as [36]

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Authors
Ferrannini, E., Vichi, S., Beck-Nielsen, H., Laakso, M., Paolisso, G., & Smith, U.
ORCID
Venue
Diabetes
Publisher
American Diabetes Association
Published
1996-07-01
Volume
45
Issue
7
Pages
947-953
ISSN
0012-1797 (ISSN-L)
DOI
10.2337/diabetes.45.7.947
OpenAlex
W2084652327
Cited by
340
References
0
Citations by year
2025: 6 · 2024: 2 · 2023: 6 · 2022: 5 · 2021: 6 · 2020: 7 · 2019: 9 · 2018: 9 · 2017: 11 · 2016: 5 · 2015: 10 · 2014: 5 · 2013: 14 · 2012: 11
FWCI
10.98
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes (publishedVersion)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords
insulin action, aging, insulin resistance, hyperinsulinemic-euglycemic clamp, m-value, body mass index, fat-free mass, lipolysis, sex differences, body composition, substrate competition, healthy adults
MeSH terms
Adult, Age Factors, Aged, Aged, 80 and over, Aging, Blood Glucose, Fasting, Fatty Acids, Nonesterified, Female, Humans, Hyperinsulinism, Infusions, Intravenous, Insulin, Insulin Resistance, Male, Middle Aged, Sex Characteristics, Glucose Clamp Technique, Body Mass Index

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