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- Title
Relative contributions of insulin resistance and β-cell dysfunction to the development of Type 2 diabetes in Koreans.
- Authors
Kim, C. ‐ H.; Kim, H. ‐ K.; Kim, E. H.; Bae, S. J.; Park, J. ‐ Y.
- Abstract
Aims Controversies still exist regarding the relative contributions of insulin resistance and β-cell dysfunction to the pathogenesis of Type 2 diabetes in different populations. We examined the associations of baseline insulin resistance and β-cell function indices with the development of Type 2 diabetes in Koreans. Methods We analysed the clinical and laboratory data of 17 878 Korean adults (age 20-79 years) who underwent routine medical examinations with a median interval of 3.5 years (range 2.5-4.7 years). Using the homeostasis model assessment, insulin resistance ( HOMA- IR) and β-cell function ( HOMA-%B) indices at baseline were assessed. Results Those who developed diabetes ( n = 732, 4.1%) had significantly higher fasting serum insulin level (53.4 ± 31.2 vs. 41.4 ± 23.4 pmol/l) and HOMA- IR (2.38 ± 1.45 vs. 1.65 ± 1.02) and lower HOMA-%B (74 ± 47 vs. 85 ± 48) at baseline ( P < 0.001 for all). Both high HOMA- IR and low HOMA-%B were independently associated with an increased odds ratio of incident Type 2 diabetes. Among the participants who developed diabetes, 29% demonstrated predominant β-cell dysfunction ( HOMA-%B < 25th percentile) and 51% had predominant insulin resistance ( HOMA- IR > 75th percentile). When we divided the participants according to the median BMI of the whole population (23.7 kg/m2), 49% of participants in the low BMI group demonstrated predominant β-cell dysfunction and 26% had predominant insulin resistance, whilst 21% in the high BMI group demonstrated mainly β-cell dysfunction and 60% had mainly insulin resistance. Conclusions In individuals with low BMI, β-cell dysfunction is the predominant defect, whereas insulin resistance is the predominant pathogenetic factor in individuals with high BMI in the development of Type 2 diabetes in Koreans.
- Subjects
KOREA; TYPE 2 diabetes diagnosis; PANCREAS; CELL physiology; DIABETES; PEOPLE with diabetes; FASTING; GLYCOSYLATED hemoglobin; HOMEOSTASIS; INSULIN resistance; MEDICINE; TYPE 2 diabetes; DATA analysis; BODY mass index; ANATOMY
- Publication
Diabetic Medicine, 2013, Vol 30, Issue 9, p1075
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.12201