1. Multi-parameter comparison of a standardized mixed meal tolerance test in healthy and type 2 diabetic subjects: the PhenFlex challenge
- Author
-
Annette Stafleu, G.C.M. Bakker, Jacobus Burggraaf, Ben van Ommen, Linette Pellis, Alwine A. F. Kardinaal, Marjan van Erk, Ruud Boessen, Johanna H. M. Stroeve, and Suzan Wopereis
- Subjects
Male ,0301 basic medicine ,Endocrinology, Diabetes and Metabolism ,Provocation test ,Biomedical Innovation ,Adipose tissue ,Physiology ,Type 2 diabetes ,Muscle tissue ,Time factor ,0302 clinical medicine ,Life ,Response time ,Nutritional challenge test ,Liver tissue ,Metabolic parameters ,Metabolic stress ,2. Zero hunger ,Glucose metabolism ,Kidney tissue ,respiratory system ,Crossover procedure ,3. Good health ,Diabetic patient ,Retrospective study ,Tissue distribution ,Vascular tissue ,Healthy Living ,lcsh:Nutrition. Foods and food supply ,Human ,Adult ,PhenFlex test ,medicine.medical_specialty ,lcsh:QH426-470 ,Clinical article ,Metabolic health ,Oral glucose tolerance test ,030209 endocrinology & metabolism ,lcsh:TX341-641 ,Clinical nutrition ,Biology ,Carbohydrate metabolism ,Health status ,03 medical and health sciences ,Diet restriction ,Metabolic regulation ,Internal medicine ,Biomarkers ,Nutrition ,Phenotypic flexibility ,Genetics ,medicine ,Exploratory research ,Human tissue ,Oral antidiabetic agent ,Aged ,Research ,Gold standard (test) ,medicine.disease ,Standardization ,Intestine tissue ,respiratory tract diseases ,lcsh:Genetics ,Glucose ,MSB - Microbiology and Systems Biology ,030104 developmental biology ,Endocrinology ,Human cell ,Pancreas tissue ,Non insulin dependent diabetes mellitus ,ELSS - Earth, Life and Social Sciences ,Controlled study ,Homeostasis - Abstract
Background A key feature of metabolic health is the ability to adapt upon dietary perturbations. Recently, it was shown that metabolic challenge tests in combination with the new generation biomarkers allow the simultaneous quantification of major metabolic health processes. Currently, applied challenge tests are largely non-standardized. A systematic review defined an optimal nutritional challenge test, the “PhenFlex test” (PFT). This study aimed to prove that PFT modulates all relevant processes governing metabolic health thereby allowing to distinguish subjects with different metabolic health status. Therefore, 20 healthy and 20 type 2 diabetic (T2D) male subjects were challenged both by PFT and oral glucose tolerance test (OGTT). During the 8-h response time course, 132 parameters were quantified that report on 26 metabolic processes distributed over 7 organs (gut, liver, adipose, pancreas, vasculature, muscle, kidney) and systemic stress. Results In healthy subjects, 110 of the 132 parameters showed a time course response. Patients with T2D showed 18 parameters to be significantly different after overnight fasting compared to healthy subjects, while 58 parameters were different in the post-challenge time course after the PFT. This demonstrates the added value of PFT in distinguishing subjects with different health status. The OGTT and PFT response was highly comparable for glucose metabolism as identical amounts of glucose were present in both challenge tests. Yet the PFT reports on additional processes, including vasculature, systemic stress, and metabolic flexibility. Conclusion The PFT enables the quantification of all relevant metabolic processes involved in maintaining or regaining homeostasis of metabolic health. Studying both healthy subjects and subjects with impaired metabolic health showed that the PFT revealed new processes laying underneath health. This study provides the first evidence towards adopting the PFT as gold standard in nutrition research. Electronic supplementary material The online version of this article (10.1186/s12263-017-0570-6) contains supplementary material, which is available to authorized users.
- Published
- 2017