Yukako Tatsumi1, Akiko Morimoto2, Naomi Miyamatsu2, Mitsuhiko Noda3, Yuko Ohno4, Kijyo Deura5. 1. Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Osaka. Electronic address: y-tatumi@sahs.med.osaka-u.ac.jp. 2. Department of Clinical Nursing, Shiga University of Medical Science, Shiga. 3. Department of Diabetes Research, National Center for Global Health and Medicine, Tokyo. 4. Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Osaka. 5. Complete Health Check Center, Saku Central Hospital, Nagano, Japan.
Abstract
BACKGROUND: Although the association between obesity and diabetes is well known, the factors predisposing to diabetes in non-obese Asians are less clearly characterized. PURPOSE: To investigate the effects of impaired insulin secretion (IIS) and insulin resistance (IR) according to BMI on the incidence of diabetes in the Saku Study. METHODS: This 4-year cohort study involved 3,083 participants aged 30-69 years without diabetes at baseline (2006-2007). Participants were stratified by BMI (<23.0, 23.0-24.9, and ≥25). Based on insulinogenic index and homeostasis model of IR values, participants were classified into four categories: normal; isolated IIS (i-IIS); isolated IR (i-IR); and IIS plus IR. All data were collected in 2006-2011 and analyzed in 2013-2014. RESULTS: For participants with BMI <23.0, the risk of developing diabetes was higher in the i-IIS (adjusted hazard ratio=6.6; 95% CI=3.7, 11.6) and IIS plus IR groups (9.4; 3.1, 28.4) than in the normal group. For participants with BMI 23.0-24.9, risk was higher in the i-IIS (9.9; 4.4, 22.1); i-IR (3.4; 1.2, 9.5); and IIS plus IR (23.4; 9.3, 58.9) groups. Among participants with BMI ≥25, risk was higher in the i-IIS (16.9; 6.0, 47.7); i-IR (7.9; 2.8, 22.6); and IIS plus IR (26.9; 9.0, 80.8) groups. BMI was negatively associated with incidence of IIS but positively associated with IR incidence. CONCLUSIONS: Individuals with normal BMI may develop diabetes mainly through IIS, whereas individuals with high BMI may develop diabetes primarily through IR.
BACKGROUND: Although the association between obesity and diabetes is well known, the factors predisposing to diabetes in non-obese Asians are less clearly characterized. PURPOSE: To investigate the effects of impaired insulin secretion (IIS) and insulin resistance (IR) according to BMI on the incidence of diabetes in the Saku Study. METHODS: This 4-year cohort study involved 3,083 participants aged 30-69 years without diabetes at baseline (2006-2007). Participants were stratified by BMI (<23.0, 23.0-24.9, and ≥25). Based on insulinogenic index and homeostasis model of IR values, participants were classified into four categories: normal; isolated IIS (i-IIS); isolated IR (i-IR); and IIS plus IR. All data were collected in 2006-2011 and analyzed in 2013-2014. RESULTS: For participants with BMI <23.0, the risk of developing diabetes was higher in the i-IIS (adjusted hazard ratio=6.6; 95% CI=3.7, 11.6) and IIS plus IR groups (9.4; 3.1, 28.4) than in the normal group. For participants with BMI 23.0-24.9, risk was higher in the i-IIS (9.9; 4.4, 22.1); i-IR (3.4; 1.2, 9.5); and IIS plus IR (23.4; 9.3, 58.9) groups. Among participants with BMI ≥25, risk was higher in the i-IIS (16.9; 6.0, 47.7); i-IR (7.9; 2.8, 22.6); and IIS plus IR (26.9; 9.0, 80.8) groups. BMI was negatively associated with incidence of IIS but positively associated with IR incidence. CONCLUSIONS: Individuals with normal BMI may develop diabetes mainly through IIS, whereas individuals with high BMI may develop diabetes primarily through IR.
Authors: Keming Yang; Michele R Forman; Patrick O Monahan; Brett H Graham; Andrew T Chan; Xuehong Zhang; Immaculata De Vivo; Edward L Giovannucci; Fred K Tabung; Hongmei Nan Journal: J Nutr Date: 2020-08-01 Impact factor: 4.798
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