{"doi":"10.3389/fnut.2022.877696","title":"Assessing Insulin Sensitivity and Postprandial Triglyceridemic Response Phenotypes With a Mixed Macronutrient Tolerance Test","abstract":"The use of meal challenge tests to assess postprandial responses in carbohydrate and fat metabolism is well established in clinical nutrition research. However, challenge meal compositions and protocols remain a variable. Here, we validated a mixed macronutrient tolerance test (MMTT), containing 56-g palm oil, 59-g sucrose, and 26-g egg white protein for the parallel determination of insulin sensitivity and postprandial triglyceridemia in clinically healthy subjects. The MMTT was administered in two study populations. In one, women with overweight/obese BMIs ( n = 43) involved in an 8-week dietary intervention were administered oral glucose tolerance tests (OGTTs) and MMTTs within 2 days of each other after 0, 2, and 8 weeks of the dietary intervention. In the other, 340 men and women between 18 and 64 years of age, with BMI from 18–40 kg/m 2 , completed the MMTT as part of a broad nutritional phenotyping effort. Postprandial blood collected at 0, 0.5, 3, and 6 h was used to measure glucose, insulin, and clinical lipid panels. The MMTT postprandial insulin-dependent glucose disposal was evaluated by using the Matsuda Index algorithm and the 0- and 3 h blood insulin and glucose measures. The resulting MMTT insulin sensitivity index (ISI MMTT ) was strongly correlated ( r = 0.77, p < 0.001) with the OGTT-dependent 2 h composite Matsuda index (ISI Composite ), being related by the following equation: Log (ISI Composite ) = [0.8751 x Log(ISI MMTT )] –0.2115. An area under the triglyceride excursion curve >11.15 mg/mL h –1 calculated from the 0, 3, and 6 h blood draws established mild-to-moderate triglyceridemia in agreement with ∼20% greater prevalence of hypertriglyceridemia than fasting indications. We also demonstrated that the product of the 0 to 3 h and 3 to 6 h triglyceride rate of change as a function of the triglyceride incremental area under the curve optimally stratified subjects by postprandial response patterns. Notably, ∼2% of the population showed minimal triglyceride appearance by 6 h, while ∼25% had increasing triglycerides through 6 h. Ultimately, using three blood draws, the MMTT allowed for the simultaneous determination of insulin sensitivity and postprandial triglyceridemia in individuals without clinically diagnosed disease. Clinical Trial Registration [ https://clinicaltrials.gov/ ], identifier [NCT02298725; NCT02367287].","journal":"Frontiers in Nutrition","year":2022,"id":258668,"datarank":0.5499629844227368,"base_score":2.8903717578961645,"endowment":2.8903717578961645,"self_citation_contribution":0.4335557636844247,"citation_network_contribution":0.11640722073831207,"self_endowment_contribution":0.4335557636844247,"citer_contribution":0.11640722073831207,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":9,"citers_with_citation_signal":5,"citers_with_endowment":5,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9568,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT02367287","NCT02298725"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":535331,"name":"Sridevi Krishnan","orcid":"0000-0003-2757-6934","position":1,"is_corresponding":false},{"id":376244,"name":"Kamil Borkowski","orcid":"0000-0003-3637-3450","position":2,"is_corresponding":false},{"id":273743,"name":"Sean H. Adams","orcid":"0000-0002-9515-2319","position":3,"is_corresponding":false},{"id":235511,"name":"Charles B. Stephensen","orcid":"0000-0002-2117-2237","position":4,"is_corresponding":false},{"id":474608,"name":"Nancy L. Keim","orcid":"0000-0002-6601-7572","position":5,"is_corresponding":false},{"id":245218,"name":"John W. Newman","orcid":"0000-0001-9632-6571","position":0,"is_corresponding":true}],"reference_count":61,"raw_metadata":null,"created_at":"2026-07-19T00:25:43.037820Z","pmid":"35634390","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}