Insulin-Stimulated Glucose Disposal Is not Increased in Anorexia Nervosa*

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Abstract
Insulin-stimulated glucose disposal was investigated using the euglycemic hyperinsulinemic glucose clamp technique in six women with anorexia nervosa (27.3 ± 4.9 yr old;weight, 38.8 ± 6.6 kg) and compared to results obtained in sixnormal women (22.6 ± 1.2 yr old; weight, 58 ± 2.5 kg) and sevenobese women (26.8 ± 7.7 yr old; weight, 92.5 ± 13.8 kg). Theglucose clamp was performed for 2 h using the Biostator and acontinuous insulin infusion of 100 mU kg,1 h,1. Plasma levelsof insulin were determined at 30-min intervals. Plasma levels ofglucagon, FFA, glycerol, 3-hydroxy-butyrate, and alanine weremeasured basally. Blood glucose levels were similar in normalsubjects and anorectic patients; they were slightly but significantlyhigher in the obese patients. The indices of insulinsensitivity measured were the MCR of glucose and the ratio ofglucose infused to insulin infused (G/I). They were very similarin anorectic subjects ±MCR, 13.5 ± 2.4 (±SEM) ml kg,1 min,1;G/I, 5.2 ± 0.9 mg/mU) and normal subjects (MCR, 13.5 ± 1.7ml kg"1 min,1; G/I, 5.2 ± 0.4 mg/mU), but were significantlyreduced in obese patients (MCR, 5.1 ± 0.8 ml kg,1 min,1; G/I,2.6 ± 0.3 mg/mU; P < 0.0025). Differences in plasma insulinamong the three groups were not statistically significant. Plasmaalanine levels were higher in anorectic than in normal or obesesubjects, suggesting defective gluconeogenesis. Thus, insulin stimulated glucose disposal is normal in patients with anorexianervosa, a finding that contrasts with the previously reportedincrease in erythrocyte insulin receptors in this disease. (J ClinEndocrinol Metab60: 311, 1985)