Differential Islet and Incretin Hormone Responses in Morning vs. Afternoon after Standardized Meal in Healthy Men

Context: The insulin response to meal ingestion is more rapid in the morning than in the afternoon. Whether this is explained by a corresponding variation in the incretin hormones is not known. Objective: Assess islet and incretin hormones after meal ingestion in the morning versus afternoon. Design, Settings and Participants: Ingestion at 8am and at 5pm of a standardized meal (524 kcal) in healthy lean males (n=12) at a University Clinical Research Unit. Main Outcome Measures: 1)Early (30 min) area under the curve (AUC30) of plasma levels of insulin and intact (i) and total (t) glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) after meal ingestion. 2)Estimation of ss-cell function by model analysis of glucose and C-peptide. Results: Peak glucose was lower in the morning than in the afternoon (6.1+/-0.2 vs. 7.4+/-0.3 mmol/l, P=0.001). AUC30insulin (4.9+/-0.6 vs 2.8+/-0.4 nmol/l*30 min; P=0.012), AUC30tGLP-1 (300+/-40 vs. 160+/-30 pmol/l*30 min, P=0.002), AUC30iGIP (0.7+/-0.1 vs. 0.3+/-0.1 nmol/l* 30 min, P=0.002) and AUC30tGIP (1.1+/-0.1 vs. 0.6+/-0.1nmol/l*min, P=0.007) were all higher in the morning. AUC30iGLP-1 (r=0.68, P=0.021) and AUC39iGIP (r=0.78, P=0.001) both correlated to AUC30insulin. Model analysis of ss-cell function showed a higher first hour potentiation factor in the morning (P=0.009). This correlated negatively with the 60 min glucose level (r=-0.63, P<0.001). Conclusions: The early release of GLP-1 and GIP are more pronounced in the morning than in the afternoon. This may contribute to the more rapid early insulin response, more pronounced potentiation of ss-cell function and lower glucose after the morning meal.