Calculates surrogate indices of glucagon resistance / failure of glucose-induced glucagon suppression, reflecting impaired hepatic glucagon signaling as described in the liver-alpha-cell-axis literature.
Details
Expected units: glucagon and insulin in a consistent molar unit (e.g. pmol/L), measured at fasting (0 min) and 120 min after a 75 g OGTT. If a required column is missing, the corresponding index is skipped with a warning.
Indices calculated:
Glucagon_suppression_ratio:Glucagon120 / Glucagon0. Values at or above 1 indicate failure to suppress glucagon after a glucose load, a marker of glucagon resistance.Glucagon_insulin_ratio: fastingGlucagon0 / I0, reported to correlate with whole-body insulin sensitivity and beta-cell function.
References
Chen X, Maldonado E, DeFronzo RA, Tripathy D (2021). Impaired Suppression of Glucagon in Obese Subjects Parallels Decline in Insulin Sensitivity and Beta-Cell Function. J Clin Endocrinol Metab, 106(5), 1398-1409. doi:10.1210/clinem/dgab019
Examples
data(example_data)
glucagon_resistance(example_data)
#> G0 G30 G120 I0 I30 I120 sex bmi Glucagon0 Glucagon30 Glucagon120
#> 1 5.71 8.39 5.59 56.4 283.5 171.5 0 19.3 3.33 2.58 3.72
#> 2 5.06 8.45 6.31 39.7 153.9 115.1 0 29.4 13.71 10.10 6.92
#> 3 4.59 7.85 6.16 87.5 512.8 257.1 0 26.6 6.28 4.27 4.58
#> 4 5.29 7.72 7.01 71.7 390.1 67.7 1 21.4 11.36 8.71 8.77
#> 5 5.13 8.27 5.78 31.3 182.5 90.7 0 31.0 11.98 8.02 9.56
#> 6 5.20 9.56 5.12 52.9 374.3 155.3 1 27.7 9.40 7.17 9.05
#> 7 5.39 8.95 8.11 41.6 291.2 104.8 1 24.8 8.06 5.92 8.85
#> 8 5.01 8.24 5.79 42.4 221.1 172.1 1 29.6 10.50 6.71 9.53
#> 9 5.52 8.38 5.68 78.8 546.2 129.9 0 29.5 11.32 8.90 12.30
#> 10 5.09 6.65 6.01 72.5 296.1 171.5 0 29.3 12.65 9.67 12.55
#> 11 5.37 9.48 6.33 51.8 264.2 135.8 1 28.8 3.84 2.48 2.26
#> 12 5.75 7.78 8.28 38.2 218.7 125.8 1 28.2 5.09 3.91 3.05
#> 13 5.42 9.21 6.72 77.9 553.7 165.6 1 25.8 14.29 10.40 8.92
#> 14 5.04 9.77 7.14 67.1 384.5 77.4 0 24.8 13.14 9.65 10.27
#> 15 5.77 7.81 6.37 30.5 182.8 93.6 1 24.5 11.31 9.61 6.30
#> 16 5.70 9.46 7.16 50.9 239.6 90.9 0 23.2 12.15 9.91 7.84
#> 17 5.47 8.46 6.28 25.9 179.0 54.8 1 25.2 12.75 9.40 11.12
#> 18 5.32 7.26 6.63 27.7 141.1 41.6 0 20.9 2.02 1.53 1.54
#> 19 4.89 6.88 5.02 23.1 74.8 42.5 0 34.7 13.33 8.97 11.56
#> 20 5.88 7.80 5.51 46.5 294.4 134.0 0 30.8 8.55 5.32 8.89
#> 21 4.90 7.68 8.50 27.0 179.6 72.7 0 21.5 10.69 7.67 9.81
#> 22 6.29 8.32 8.21 57.1 293.8 98.1 1 24.4 9.11 5.50 6.87
#> 23 5.97 9.72 5.67 98.9 619.9 295.7 0 24.1 12.62 10.86 12.13
#> 24 5.08 9.96 5.55 52.9 189.4 185.1 0 29.1 8.95 8.04 5.11
#> 25 4.69 6.86 4.47 49.0 226.9 113.8 0 25.7 11.56 9.39 7.84
#> 26 4.84 8.67 8.68 52.4 334.8 102.3 0 27.0 8.83 7.49 7.82
#> 27 5.33 9.15 8.10 78.0 362.8 133.6 1 25.9 6.72 5.83 4.06
#> 28 5.08 8.55 5.96 47.2 246.4 24.7 1 25.8 13.63 10.38 14.38
#> 29 5.03 7.42 6.88 56.1 272.9 144.8 0 31.5 12.22 9.37 12.84
#> 30 4.72 7.82 5.42 89.7 607.9 231.0 1 25.1 15.17 10.36 12.30
#> 31 5.18 8.16 5.81 121.9 542.2 314.1 0 32.1 10.20 8.14 10.23
#> 32 4.81 8.46 5.06 97.3 628.3 307.7 1 19.8 13.38 9.01 9.26
#> 33 4.37 7.27 4.86 51.9 224.1 117.2 0 28.3 15.93 10.94 8.64
#> 34 5.01 8.99 8.19 71.0 365.7 141.2 1 26.5 9.16 7.46 7.20
#> 35 5.66 8.56 6.80 79.6 457.3 203.7 1 26.9 6.03 4.93 4.83
#> 36 4.91 8.95 6.25 41.8 159.8 107.9 0 27.5 9.28 6.05 6.70
#> 37 5.50 7.86 6.99 79.9 321.3 197.4 0 24.0 9.36 6.48 5.81
#> 38 4.39 6.58 7.07 72.2 524.2 168.9 0 24.7 10.46 7.44 8.68
#> 39 5.17 10.96 5.75 27.1 116.0 119.5 0 21.9 15.14 9.44 7.76
#> 40 5.46 8.33 5.47 48.4 298.6 86.8 1 21.7 9.02 7.34 9.05
#> 41 5.35 8.79 8.56 59.2 397.5 138.7 0 27.2 11.12 8.51 9.61
#> 42 5.25 8.96 5.92 56.8 338.0 103.3 1 27.8 9.32 5.97 8.55
#> 43 4.88 7.69 5.21 65.5 461.1 183.9 1 26.2 10.06 8.98 8.09
#> 44 4.78 8.39 4.50 55.6 238.0 163.6 0 29.7 10.94 8.41 7.46
#> 45 4.69 8.19 4.35 22.8 152.3 82.0 0 34.2 13.98 11.69 11.18
#> 46 5.26 8.29 5.77 37.1 195.4 95.9 0 24.0 10.36 8.85 10.52
#> 47 4.73 7.98 6.67 48.9 360.8 139.8 0 16.8 12.14 10.48 10.69
#> 48 4.95 8.12 7.48 86.8 441.2 248.8 1 30.0 12.34 10.37 9.34
#> 49 5.07 9.97 7.12 90.2 385.2 172.7 0 23.2 12.74 10.09 13.09
#> 50 6.12 8.73 6.88 50.6 263.2 123.0 0 23.2 8.28 6.53 5.85
#> Glucagon_suppression_ratio Glucagon_insulin_ratio
#> 1 1.1171171 0.05904255
#> 2 0.5047411 0.34534005
#> 3 0.7292994 0.07177143
#> 4 0.7720070 0.15843794
#> 5 0.7979967 0.38274760
#> 6 0.9627660 0.17769376
#> 7 1.0980149 0.19375000
#> 8 0.9076190 0.24764151
#> 9 1.0865724 0.14365482
#> 10 0.9920949 0.17448276
#> 11 0.5885417 0.07413127
#> 12 0.5992141 0.13324607
#> 13 0.6242127 0.18344031
#> 14 0.7815830 0.19582712
#> 15 0.5570292 0.37081967
#> 16 0.6452675 0.23870334
#> 17 0.8721569 0.49227799
#> 18 0.7623762 0.07292419
#> 19 0.8672168 0.57705628
#> 20 1.0397661 0.18387097
#> 21 0.9176801 0.39592593
#> 22 0.7541164 0.15954466
#> 23 0.9611727 0.12760364
#> 24 0.5709497 0.16918715
#> 25 0.6782007 0.23591837
#> 26 0.8856172 0.16851145
#> 27 0.6041667 0.08615385
#> 28 1.0550257 0.28877119
#> 29 1.0507365 0.21782531
#> 30 0.8108108 0.16911929
#> 31 1.0029412 0.08367514
#> 32 0.6920777 0.13751285
#> 33 0.5423729 0.30693642
#> 34 0.7860262 0.12901408
#> 35 0.8009950 0.07575377
#> 36 0.7219828 0.22200957
#> 37 0.6207265 0.11714643
#> 38 0.8298279 0.14487535
#> 39 0.5125495 0.55867159
#> 40 1.0033259 0.18636364
#> 41 0.8642086 0.18783784
#> 42 0.9173820 0.16408451
#> 43 0.8041750 0.15358779
#> 44 0.6819013 0.19676259
#> 45 0.7997139 0.61315789
#> 46 1.0154440 0.27924528
#> 47 0.8805601 0.24826176
#> 48 0.7568882 0.14216590
#> 49 1.0274725 0.14124169
#> 50 0.7065217 0.16363636