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Differential role of insulin resistance and β-cell function in the development of prediabetes and diabetes in middle-aged and elderly Chinese population.

Abstract：

Background:The prevalence of diabetes and prediabetes were estimated to be 10.9% and 35.7% in the Chinese adult population, respectively, and the middle-aged and elderly Chinese are at even higher risk of diabetes and prediabetes than younger population. With the increasing trend of aging in China, the burden of diabetes and related complications will be aggravated. Objectives:Through comparing the indices of insulin resistance and β-cell function between subjects with different glucose metabolic status, to analyze the differential role of insulin resistance and β-cell function in the development of prediabetes and type 2 diabetes (T2DM) in the middle-aged and elderly Chinese population. Methods:In this cross-sectional study, we enrolled 512 participants aged 50 and over. The indices of insulin resistance (homoeostasis model assessment of insulin resistance (HOMA-IR) and adipose tissue insulin resistance (Adipo-IR), and indices of β-cell function [HOMA-β), fasting C-peptide to glucose ratio (FCPRI) and postprandial C-peptide to glucose ratio (PCPRI)] were calculated. Association of insulin resistance and β-cell function with prediabetes or T2DM were evaluated by multivariate logistic regression analysis, in which potential confounding factors were adjusted. Results:Of the 509 participants with complete information, 263 (51.7%) had normal glucose tolerance (NGT), 161 (31.6%) were in prediabetic status and 85 (16.7%) were overt T2DM. With the advancing of unfavorable glucose metabolism, the insulin resistance (HOMA-IR and Adipo-IR) and β-cell function (FCPRI, PCPRI) deteriorated (Ptrend < 0.05 for all indices). We found that increase in insulin resistance expressed by Adipo-IR and HOMA-IR is associated with increased risk of prediabetes, whereas decrease in β-cell function expressed by HOMA-β and PCPRI is associated with increased risk of T2DM. We also demonstrated that Adipo-IR was more closely associated with developing prediabetes than HOMA-IR, and PCPRI was most closely related with developing T2DM among the indices of β-cell function used in this study. Conclusions:Insulin resistance is the main determinant of developing prediabetes, whereas β-cell function is the main determinant of developing T2DM.

journal_name

Diabetol Metab Syndr

journal_title

Diabetology & metabolic syndrome

authors

Cai X,Xia L,Pan Y,He D,Zhu H,Wei T,He Y

doi

10.1186/s13098-019-0418-x

subject

Has Abstract

pub_date

2019-03-05 00:00:00

pages

issn

1758-5996

pii

418

journal_volume

pub_type

杂志文章

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Differential role of insulin resistance and β-cell function in the development of prediabetes and diabetes in middle-aged and elderly Chinese population.