Impaired feedback control of fat induced gastric inhibitory polypeptide (GIP) secretion by insulin in obesity and glucose intolerance

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Abstract
To investigate the role of endogenous insulin on the secretion of immunoreactive gastric inhibitory polypeptide (IR‐GIP) the response of IR‐GIP and immunoreactive insulin (IRI) to an oral fat load (100 g triglyceride) alone and during an intravenous glucose infusion (0.7 g/kg/h) was examined in normal weight and obese subjects. In normal weight subjects the fat induced integrated rise of IR‐GIP was 112.7 ± 9.4 ng/ml/120 min. When glucose and fat were given together this IR‐GIP response was lowered to 46.2 ± 2.9 ng/ml/120 min while the serum IRI response to i.v. glucose and the glucose tolerance were enhanced by fat ingestion. In obese subjects with normal glucose tolerance the GIP suppressing effect of i.v. glucose infusion was less marked than in controls. The integrated IR‐GIP response to fat ingestion was 225.6 ± 20.3 ng/ml/120 min and to fat plus glucose 152.6 ± 14.8 ng/ml/120 min. In obese subjects with glucose intolerance i.v. glucose completely failed to lower the exaggerated secretion of IR‐GIP following oral fat. Thus, a graded abnormality of the GIP response to glucose induced insulin release occurs in obesity with normal and pathological glucose tolerance. After reducing the ideal body weight of six obese subjects with glucose intolerance by hypocaloric diet for 3 weeks the exaggerated rise of IR‐GIP after oral fat was reversed and the lowering effect of i.v. glucose on the IR‐GIP response re‐established.