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However, its utility in discriminating between individuals with varying degrees of \u03b2\u2010cell dysfunction is unclear. Proinsulin has a very different half\u2010life to insulin and unlike insulin does not undergo hepatic extraction prior to reaching the systemic circulation. Given these limitations, we sought to examine the relationship between fasting and postprandial concentrations of \u03b2\u2010cell polypeptides (proinsulin, insulin and C\u2010peptide) in people with normal and impaired glucose tolerance in differing metabolic environments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Subjects were studied on two occasions in random order while undergoing an oral challenge. During one study day, free fatty acids were elevated (to induce insulin resistance) by infusion of Intralipid with heparin. Proinsulin to insulin and proinsulin to C\u2010peptide ratios were calculated for the 0\u2010, 30\u2010, 60\u2010 and 240\u2010minute time points. Insulin action (Si) and \u03b2\u2010cell responsivity (\u03a6) indices were calculated using the oral minimal model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The fasting proinsulin to c\u2010peptide or fasting proinsulin to insulin ratios did not differ between groups and did not predict subsequent \u03b2\u2010cell responsivity to glucose during the glycerol or Intralipid study days in either group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among nondiabetic individuals, the fasting proinsulin to insulin ratio is not a useful marker of \u03b2\u2010cell function.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.13469","type":"journal-article","created":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T08:14:51Z","timestamp":1607501691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Limitations of the fasting proinsulin to insulin ratio as a measure of \u03b2\u2010cell health in people with and without impaired glucose tolerance"],"prefix":"10.1111","volume":"51","author":[{"given":"Aoife M.","family":"Egan","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcello C.","family":"Laurenti","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Daniela","family":"Hurtado Andrade","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Dalla Man","sequence":"additional","affiliation":[{"name":"Department of Information Engineering Universit\u00e0 degli Studi di Padova Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Cobelli","sequence":"additional","affiliation":[{"name":"Department of Information Engineering Universit\u00e0 degli Studi di Padova Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kent R.","family":"Bailey","sequence":"additional","affiliation":[{"name":"Division of Biomedical Statistics and Informatics Mayo Clinic Rochester MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6493-7837","authenticated-orcid":false,"given":"Adrian","family":"Vella","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism Mayo Clinic Rochester MN 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