Difference between old and young adults in contribution of β-cell function and sarcopenia in developing diabetes mellitus.

Koo, Bo Kyung; Roh, Eun; Yang, Ye Seul; Moon, Min Kyong

Aims/Introduction To investigate the difference in contributing factors in developing diabetes between old and young adults. Materials and Methods Subjects with recent-onset diabetes were selected from a nationwide survey data and classified according to age: elderly (age ≥75 years), middle-age (age 45-64 years) and young (age 25-39 years). The homeostasis model assessment of insulin resistance and β-cell function were calculated. Sarcopenia was assessed using dual-energy X-ray absorptiometry. Results The prevalence of recent-onset diabetes was 13.5%, 8.0%, and 1.4% in patients aged ≥75 years (unweighted n = 1,082), 45-64 years (unweighted n = 6,532), and 25-39 years (unweighted n = 5,178), respectively. Homeostasis model assessment of β-cell function along with homeostasis model assessment of insulin resistance showed increasing trends as onset age increased in recent-onset diabetes ( P for trend < 0.001 in both). Elderly-onset diabetic patients had significantly higher homeostasis model assessment of β-cell function and homeostasis model assessment of insulin resistance compared with the middle-age-onset group ( P < 0.001 and 0.014, respectively). Multivariate analysis showed that sarcopenia was significantly associated with recent-onset diabetes only in patients aged ≥75 years (odds ratio [ OR] 2.478, 95% confidence interval [ CI] 1.379-4.452) but not in patients aged 45-64 years. In the middle-age group, abdominal obesity ( OR 2.933, 95% CI 2.086-4.122), hypertriglyceridemia ( OR 1.529, 95% CI 1.078-2.169]) and low high-density lipoprotein cholesterolemia ( OR 1.930, 95% CI 1.383-2.695) were associated with recent-onset diabetes. Conclusions Elderly-onset diabetic patients had higher insulin resistance and relatively preserved β-cell function compared with middle-age-onset patients. Sarcopenia might play a more important role in developing diabetes in the elderly population.

DIABETES; SARCOPENIA; B cells; HOMEOSTASIS; INSULIN resistance

Journal of Diabetes Investigation, 2016, Vol 7, Issue 2, p233

2040-1116

Academic Journal

10.1111/jdi.12392