{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T04:37:47Z","timestamp":1770698267398,"version":"3.49.0"},"reference-count":31,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Background: Obesity is associated with a broad range of complications that frequently develop before the onset of type 2 diabetes mellitus (T2DM). Identifying early metabolic markers associated with such complications is essential for improving risk stratification and supporting complication-driven therapeutic strategies. Plasma glucose measured at 1 h during the oral glucose tolerance test (OGTT) has emerged as a sensitive marker of early dysglycemia and adverse cardiometabolic outcomes, but its relationship with established obesity-related complications in individuals without diabetes remains incompletely characterized. We aimed to investigate the association between 1 h post-load plasma glucose levels during OGTT and obesity-related complications in adults living with obesity without T2DM. Methods: This observational cross-sectional study included 47 adults with obesity evaluated during their first visit to obesity clinics. Individuals with T2DM or prior use of anti-obesity pharmacotherapy were excluded. All participants underwent a standard 75-g OGTT with plasma glucose and insulin measurements at fasting, 1 h, and 2 h. Obesity-related complications were recorded retrospectively through structured questionnaires, clinical assessment, and medical record review. Between-group comparisons were performed using non-parametric tests, and repeated OGTT measurements were analyzed using non-parametric longitudinal models. Results: Higher 1 h post-load glucose levels were observed in participants with arterial hypertension (p &lt; 0.001), dyslipidemia (p = 0.020), metabolic dysfunction-associated steatotic liver disease (p = 0.005), impaired glucose tolerance (p = 0.027), obesity hypoventilation syndrome (p = 0.039), urinary incontinence (p = 0.038), and chronic kidney disease (p = 0.048). In most comparisons, 1 h post-load glucose demonstrated stronger discriminatory capacity than fasting or 2 h glucose values. Insulin levels increased markedly after glucose loading in all participants, reflecting generalized insulin resistance, but showed limited ability to discriminate between complication phenotypes. Conclusions: In people living with obesity without T2DM, elevated 1 h post-load plasma glucose during OGTT is consistently associated with multisystem obesity-related complications. These findings support the clinical relevance of 1 h post-load glucose as an integrated marker of early metabolic and systemic burden that may inform complication-driven risk stratification in obesity. Due to the observational study design, causality cannot be inferred.<\/jats:p>","DOI":"10.3390\/biom16020268","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T09:41:02Z","timestamp":1770630062000},"page":"268","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["One-Hour Post-Load Glucose Is Associated with Multisystem Complications in People Living with Obesity"],"prefix":"10.3390","volume":"16","author":[{"given":"Ioanna","family":"Mixaki","sequence":"first","affiliation":[{"name":"Medical School, Aristotle University, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michalis G.","family":"Prokopakis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2351-7411","authenticated-orcid":false,"given":"Georgios","family":"Dimakopoulos","sequence":"additional","affiliation":[{"name":"BIOSTATS, Epirus Science and Technology Park Campus, University of Ioannina, 45110 Ioannina, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1713-0923","authenticated-orcid":false,"given":"Theodosios D.","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2376-740X","authenticated-orcid":false,"given":"Kalliopi","family":"Kotsa","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5853-1352","authenticated-orcid":false,"given":"Theocharis","family":"Koufakis","sequence":"additional","affiliation":[{"name":"Second Propaedeutic Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1007\/s00424-025-03066-8","article-title":"The obesity pandemic and its impact on non-communicable disease burden","volume":"477","author":"Hildebrand","year":"2025","journal-title":"Pflugers Arch."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S2213-8587(24)00316-4","article-title":"Definition and diagnostic criteria of clinical obesity","volume":"13","author":"Rubino","year":"2025","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/dom.16263","article-title":"An overview of obesity-related complications: The epidemiological evidence linking body weight and other markers of obesity to adverse health outcomes","volume":"27","year":"2025","journal-title":"Diabetes Obes. 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