Journal of Applied Physiology
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J Appl Physiol 91: 872-881, 2001;
8750-7587/01 $5.00
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Vol. 91, Issue 2, 872-881, August 2001

Sequential hyperglycemic-euglycemic clamp to assess beta -cell and peripheral tissue: studies in female athletes

Alice S. Ryan1, Denis C. Muller2, and Dariush Elahi1

1 Division of Gerontology, Department of Medicine, University of Maryland School of Medicine, and Geriatrics Service/Geriatric Research, Education, and Clinical Center, Baltimore Veterans Affairs Medical Center, Baltimore 21201; and 2 Laboratory of Clinical Physiology, Gerontology Research Center, National Institute on Aging, Baltimore, Maryland 21224

Insulin secretion and rate of utilization (Rd) of glucose were tested during a newly developed sequential clamp in 42 highly trained female athletes (A; 18-69 yr old) and 14 sedentary control women (C; 18-50 yr old; body mass index <25 kg/m2). The A women were categorized into four age groups: 18-29, 30-39, 40-49, and 50-69 yr old. The C women were also grouped by age (18-29 and 40-50 yr old). During the three-step clamp (hyperglycemia, return to euglycemia, and hyperinsulinemia), glucose turnover was assessed with [3-3H]glucose. Among the A, the youngest group had the largest first- and second-phase insulin response, which was significantly different from the oldest A (P < 0.05). Among the two C groups, first-phase response of both groups and second-phase response of the older group was higher than respective age-matched A (P < 0.05). During the hyperglycemic period, glucose Rd was similar among A groups and between A and C. Despite similar levels of insulin between groups during the hyperinsulinemic period (~400 pmol/l), A utilized 36% more glucose than C (P < 0.001). Glucose Rd was not different across the age groups of A. This newly developed sequential clamp procedure allows assessment of both beta -cell sensitivity to glucose and peripheral tissue sensitivity to insulin in a single session. We have shown that physical activity improves beta -cell efficiency across the age span in women and ameliorates the effect of age on the decline of peripheral tissue sensitivity to insulin.

glucose kinetics; maximal oxygen uptake; insulin secretion


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