The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

Associations among Body Mass Index, Insulin Resistance, and Pancreatic ${\beta}-Cell$ Function in Korean Patients with New-Onset Type 2 Diabetes

  • Chung, Jin-Ook (Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Cho, Dong-Hyeok (Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Chung, Dong-Jin (Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Chung, Min-Young (Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School)
  • Published : 2012.03.01
⟨ Previous Next ⟩

Abstract

Background/Aims: We investigated the associations among body mass index (BMI), insulin resistance, and ${\beta}-Cell$ function in Korean patients newly presenting with type 2 diabetes. Methods: In total, 132 patients with new-onset type 2 diabetes mellitus were investigated. A standard 75-g oral glucose tolerance test was performed, and the indices of insulin secretion and insulin resistance were calculated. Results: A higher BMI was associated with higher homeostasis model assessment values for insulin resistance (HOMAIR), homeostasis model assessment of ${\beta}-Cell$ function ($HOMA-{\beta}$), and insulinogenic index as well as lower levels of insulin sensitivity index composite ($ISI_{comp}$) and disposition index (DI). In multiple regression models, BMI had independent positive associations with HOMA-IR, $ISI_{comp}$, and $HOMA-{\beta}$ and inverse associations with the DI. Conclusions: Our results showed that BMI had independent positive associations with indices of insulin resistance and an inverse association with ${\beta}-Cell$ function adjusted for insulin resistance in Korean patients newly presenting with type 2 diabetes.

Keywords

References

  1. Ferrannini E. Insulin resistance versus insulin deficiency in non-insulin-dependent diabetes mellitus: problems and prospects. Endocr Rev 1998;19:477-490. https://doi.org/10.1210/er.19.4.477
  2. DeFronzo RA. Lilly lecture 1987. The triumvirate: beta-cell, muscle, liver. A collusion responsible for NIDDM. Diabetes 1988;37:667-687. https://doi.org/10.2337/diab.37.6.667
  3. Park JY, Lee KU, Kim CH, et al. Past and current obesity in Koreans with non-insulin-dependent diabetes mellitus. Diabetes Res Clin Pract 1997;35:49-56. https://doi.org/10.1016/S0168-8227(96)01363-0
  4. Rhee SY, Kim JY, Chon S, et al. The changes in early phase insulin secretion in newly diagnosed, drug naive Korean prediabetes subjects. Korean Diabetes J 2010;34:157-165. https://doi.org/10.4093/kdj.2010.34.3.157
  5. Kim DJ, Lee MS, Kim KW, Lee MK. Insulin secretory dysfunction and insulin resistance in the pathogenesis of Korean type 2 diabetes mellitus. Metabolism 2001;50:590-593. https://doi.org/10.1053/meta.2001.22558
  6. Funakoshi S, Fujimoto S, Hamasaki A, et al. Analysis of factors influencing pancreatic beta-cell function in Japanese patients with type 2 diabetes: association with body mass index and duration of diabetic exposure. Diabetes Res Clin Pract 2008;82:353-358. https://doi.org/10.1016/j.diabres.2008.09.010
  7. Juang JH, Huang HS, Huang MJ. C-peptide response to glucagon in patients with non-insulin-dependent diabetes mellitus. J Formos Med Assoc 1992;91:491-496.
  8. Chang SA, Kim HS, Yoon KH, et al. Body mass index is the most important determining factor for the degree of insulin resistance in non-obese type 2 diabetic patients in Korea. Metabolism 2004;53:142-146. https://doi.org/10.1016/S0026-0495(03)00314-7
  9. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2008;31 Suppl 1:S55-S60. https://doi.org/10.2337/dc08-S055
  10. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-419. https://doi.org/10.1007/BF00280883
  11. Matsuda M, DeFronzo RA. Insulin sensitivity indices obtained from oral glucose tolerance testing: comparison with the euglycemic insulin clamp. Diabetes Care 1999;22:1462-1470. https://doi.org/10.2337/diacare.22.9.1462
  12. Seltzer HS, Allen EW, Herron AL Jr, Brennan MT. Insulin secretion in response to glycemic stimulus: relation of delayed initial release to carbohydrate intolerance in mild diabetes mellitus. J Clin Invest 1967;46:323-335. https://doi.org/10.1172/JCI105534
  13. Kahn SE, Prigeon RL, McCulloch DK, et al. Quantification of the relationship between insulin sensitivity and beta-cell function in human subjects: evidence for a hyperbolic function. Diabetes 1993;42:1663-1672. https://doi.org/10.2337/diabetes.42.11.1663
  14. Bergman RN, Phillips LS, Cobelli C. Physiologic evaluation of factors controlling glucose tolerance in man: measurement of insulin sensitivity and beta-cell glucose sensitivity from the response to intravenous glucose. J Clin Invest 1981;68:1456-1467. https://doi.org/10.1172/JCI110398
  15. Finegood DT, Hramiak IM, Dupre J. A modified protocol for estimation of insulin sensitivity with the minimal model of glucose kinetics in patients with insulin-dependent diabetes. J Clin Endocrinol Metab 1990;70:1538-1549. https://doi.org/10.1210/jcem-70-6-1538
  16. Hermans MP, Levy JC, Morris RJ, Turner RC. Comparison of tests of beta-cell function across a range of glucose tolerance from normal to diabetes. Diabetes 1999;48:1779-1786. https://doi.org/10.2337/diabetes.48.9.1779
  17. Kim SM, Lee JS, Lee J, et al. Prevalence of diabetes and impaired fasting glucose in Korea: Korean National Health and Nutrition Survey 2001. Diabetes Care 2006;29:226-231. https://doi.org/10.2337/diacare.29.02.06.dc05-0481
  18. Qiao Q, Nyamdorj R. Is the association of type II diabetes with waist circumference or waist-to-hip ratio stronger than that with body mass index? Eur J Clin Nutr 2010;64:30-34. https://doi.org/10.1038/ejcn.2009.93
  19. Sung EJ, Sunwoo S, Kim SW, Kim YS. Obesity as a risk factor for non-insulin-dependent diabetes mellitus in Korea. J Korean Med Sci 2001;16:391-396. https://doi.org/10.3346/jkms.2001.16.4.391
  20. Campbell PJ, Carlson MG. Impact of obesity on insulin action in NIDDM. Diabetes 1993;42:405-410. https://doi.org/10.2337/diabetes.42.3.405
  21. Butler AE, Janson J, Bonner-Weir S, Ritzel R, Rizza RA, Butler PC. Beta-cell deficit and increased beta-cell apoptosis in humans with type 2 diabetes. Diabetes 2003;52:102-110. https://doi.org/10.2337/diabetes.52.1.102
  22. Yoon KH, Ko SH, Cho JH, et al. Selective beta-cell loss and alpha-cell expansion in patients with type 2 diabetes mellitus in Korea. J Clin Endocrinol Metab 2003;88:2300-2308. https://doi.org/10.1210/jc.2002-020735
  23. Pontiroli AE, Calderara A, Maffi P, et al. Secondary failure to oral hypoglycaemic agents in non-obese patients with non-insulin-dependent diabetes is related to reduced insulin release. Diabete Metab 1989;15:79-84.
  24. Arner P, Pollare T, Lithell H. Different aetiologies of type 2 (non-insulin-dependent) diabetes mellitus in obese and nonobese subjects. Diabetologia 1991;34:483-487. https://doi.org/10.1007/BF00403284
  25. Roy MN, Biswas KB, Siddiqua N, Arslan MI, Ali L. Determinants of insulin secretion and sensitivity in Bangladeshi type 2 diabetic subjects. Metab Syndr Relat Disord 2007;5:275-281. https://doi.org/10.1089/met.2006.0030

Cited by

  1. The association of depression and perceived stress with beta cell function between African and Haitian Americans with and without type 2 diabetes vol.3, pp.4, 2012, https://doi.org/10.4236/jdm.2013.34036
  2. Thyroid disease in insulin-treated patients with type 2 diabetes: a retrospective study vol.7, pp.None, 2012, https://doi.org/10.1186/1756-6614-7-2
  3. The effect of glargine versus glimepiride on pancreatic β-cell function in patients with type 2 diabetes uncontrolled on metformin monotherapy: open-label, randomized, controlled study vol.51, pp.2, 2012, https://doi.org/10.1007/s00592-013-0553-z
  4. Clinical characteristics and beta cell function in Chinese patients with newly diagnosed type 2 diabetes mellitus with different levels of serum triglyceride vol.15, pp.None, 2012, https://doi.org/10.1186/s12902-015-0018-1
  5. IMPORTANCE OF THYROID FUNCTION TEST IN DIABETES vol.2, pp.19, 2012, https://doi.org/10.18410/jebmh/2015/412
  6. A COMPARATIVE STUDY OF VARIOUS METABOLIC PARAMETERS AND INSULIN SECRETION IN OVERWEIGHT AND OBESE INDIVIDUALS vol.3, pp.50, 2016, https://doi.org/10.18410/jebmh/2016/556
  7. A Comparison Between Job Stress and Insulin Resistance Among the Hospital Medical Staff vol.4, pp.3, 2012, https://doi.org/10.5812/jamm.37872
  8. Which Patients Will Benefit from a Switch in Therapy from Premixed Insulin to Insulin Glargine plus Oral Antidiabetic Drugs? Further Analysis of the Lantus Registry Study vol.8, pp.4, 2012, https://doi.org/10.1007/s13300-017-0284-1
  9. Insulin Glargine Combined with Oral Antidiabetic Drugs for Asians with Type 2 Diabetes Mellitus: A Pooled Analysis to Identify Predictors of Dose and Treatment Response vol.9, pp.2, 2012, https://doi.org/10.1007/s13300-018-0381-9
  10. Inkretini u patogenezi dijabetesa tipa 2 vol.23, pp.71, 2012, https://doi.org/10.5937/medgla1870040r
  11. Role of incretins in the pathogenesis of type 2 diabetes vol.23, pp.71, 2012, https://doi.org/10.5937/medgla1870053r
  12. Insulin Resistance Index and Proatherogenic Lipid Indices in the Offspring of People with Diabetes vol.25, pp.1, 2012, https://doi.org/10.1159/000497079
  13. Genetic variants of two-pore calcium channel 2 rs1551305 and its association with type 2 diabetes risk vol.31, pp.None, 2019, https://doi.org/10.4103/ejim.ejim_58_18
  14. Different Analysis of β-Cell Dysfunction as Fasting Glucose Progresses in Obese and Nonobese Newly Diagnosed Type 2 Diabetic Patients vol.2019, pp.None, 2012, https://doi.org/10.1155/2019/6053604
  15. Correlation between Obesity and Lipid Profile in Type 2 Diabetes Mellitus Patients at the Endocrine and Metabolic Polyclinic in General Hospital Pirngadi Medan vol.7, pp.8, 2019, https://doi.org/10.3889/oamjms.2019.312
  16. Association among Lifestyle Factors, Obesity, C-peptide Secretion, Metabolic Syndrome, and Cardiovascular Risk in Adults with Newly Diagnosed Type 2 Diabetes Mellitus: A Case Study vol.44, pp.2, 2012, https://doi.org/10.21032/jhis.2019.44.2.125
  17. The emergence of a diabetes pocket in Nigeria: the result of a spatial analysis vol.84, pp.5, 2012, https://doi.org/10.1007/s10708-018-9911-2
  18. Insulin Resistance and β-Cell Function of Lean versus Overweight or Obese Filipino Patients with Newly Diagnosed Type 2 Diabetes Mellitus vol.34, pp.2, 2012, https://doi.org/10.15605/jafes.034.02.07
  19. A Review of Recent Evidence from Meal-Based Diet Interventions and Clinical Biomarkers for Improvement of Glucose Regulation vol.25, pp.1, 2012, https://doi.org/10.3746/pnf.2020.25.1.9
  20. The causal effect of obesity on prediabetes and insulin resistance reveals the important role of adipose tissue in insulin resistance vol.16, pp.9, 2012, https://doi.org/10.1371/journal.pgen.1009018