Differential role of insulin resistance and -cell function in the development of prediabetes and diabetes in middle-aged and elderly Chinese population
机构：[1]Department of Neurology, Lishui Municipal Central Hospital, Lishui, Zhejiang, China.[2]Editorial Office of Hepatobiliary and Pancreatic Diseases International, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.外科系统肝胆胰外科浙江大学医学院附属第一医院[3]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.重点科室诊疗科室神经病学中心首都医科大学附属天坛医院[4]Department of Epidemiology and Biostatics, School of Public Health, Capital Medical University, Beijing, China.
BackgroundThe 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.ObjectivesThrough comparing the indices of insulin resistance and -cell function between subjects with different glucose metabolic status, to analyze the differential role of insulin resistance and -cell function in the development of prediabetes and type 2 diabetes (T2DM) in the middle-aged and elderly Chinese population.MethodsIn 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 -cell function [HOMA-), fasting C-peptide to glucose ratio (FCPRI) and postprandial C-peptide to glucose ratio (PCPRI)] were calculated. Association of insulin resistance and -cell function with prediabetes or T2DM were evaluated by multivariate logistic regression analysis, in which potential confounding factors were adjusted.ResultsOf 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 -cell function (FCPRI, PCPRI) deteriorated (P-trend<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 -cell function expressed by HOMA- 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 -cell function used in this study.ConclusionsInsulin resistance is the main determinant of developing prediabetes, whereas -cell function is the main determinant of developing T2DM.
基金：
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [31672375]; National Science & Technology Pillar Program [SQ2015BA1300692]
第一作者机构：[1]Department of Neurology, Lishui Municipal Central Hospital, Lishui, Zhejiang, China.
共同第一作者：
通讯作者：
通讯机构：[1]Department of Neurology, Lishui Municipal Central Hospital, Lishui, Zhejiang, China.[4]Department of Epidemiology and Biostatics, School of Public Health, Capital Medical University, Beijing, China.
推荐引用方式(GB/T 7714)：
Cai Xueli,Xia Lili,Pan Yuesong,et al.Differential role of insulin resistance and -cell function in the development of prediabetes and diabetes in middle-aged and elderly Chinese population[J].DIABETOLOGY & METABOLIC SYNDROME.2019,11(1):-.doi:10.1186/s13098-019-0418-x.
APA：
Cai, Xueli,Xia, Lili,Pan, Yuesong,He, Dian,Zhu, Huiping...&He, Yan.(2019).Differential role of insulin resistance and -cell function in the development of prediabetes and diabetes in middle-aged and elderly Chinese population.DIABETOLOGY & METABOLIC SYNDROME,11,(1)
MLA：
Cai, Xueli,et al."Differential role of insulin resistance and -cell function in the development of prediabetes and diabetes in middle-aged and elderly Chinese population".DIABETOLOGY & METABOLIC SYNDROME 11..1(2019):-
