Tiange Wang1, Zhiyun Zhao1, Yu Xu1, Lu Qi2, Min Xu1, Jieli Lu1, Mian Li1, Yuhong Chen1, Meng Dai1, Wenhua Zhao3, Guang Ning1, Weiqing Wang1, Yufang Bi1. 1. State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. 2. Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana. 3. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China.
Abstract
Context: Insulin resistance (IR) and β-cell dysfunction are two major defects synergistically inducing the development of diabetes and related cardiometabolic disorders. Objective: To investigate the independent and joint associations of IR and β-cell dysfunction with the prevalence of multiple cardiometabolic disorders, including obesity, central obesity, diabetes, dyslipidemia, and hypertension. Design and Settings: A nationally representative population of 93,690 Chinese adults. Main Outcome Measures: IR and β-cell dysfunction were assessed by the homeostasis model assessment of IR (HOMA-IR) and of β-cell function (HOMA-B), respectively. Results: High HOMA-IR was independently associated with high prevalence of all estimated cardiometabolic disorders, whereas low HOMA-B was independently associated with high prevalence of diabetes, dyslipidemia, and hypertension but low prevalence of obesity and central obesity. When examined jointly, the associations of HOMA-IR and HOMA-B with multiple cardiometabolic disorders showed different patterns with varying magnitudes. The strongest joint associations were observed for diabetes, with low HOMA-B associated with high prevalence of diabetes regardless of HOMA-IR; joint associations with dyslipidemia and hypertension prevalence appeared to be additive and had moderate changing trends; and low HOMA-B was not associated with high prevalence of obesity or central obesity unless combined with high HOMA-IR. Conclusion: IR was associated with more prevalent cardiometabolic disorders than was β-cell dysfunction, and combinations of IR and β-cell dysfunction showed distinct relations with cardiometabolic risk patterns in Chinese adults.
Context: Insulin resistance (IR) and β-cell dysfunction are two major defects synergistically inducing the development of diabetes and related cardiometabolic disorders. Objective: To investigate the independent and joint associations of IR and β-cell dysfunction with the prevalence of multiple cardiometabolic disorders, including obesity, central obesity, diabetes, dyslipidemia, and hypertension. Design and Settings: A nationally representative population of 93,690 Chinese adults. Main Outcome Measures: IR and β-cell dysfunction were assessed by the homeostasis model assessment of IR (HOMA-IR) and of β-cell function (HOMA-B), respectively. Results: High HOMA-IR was independently associated with high prevalence of all estimated cardiometabolic disorders, whereas low HOMA-B was independently associated with high prevalence of diabetes, dyslipidemia, and hypertension but low prevalence of obesity and central obesity. When examined jointly, the associations of HOMA-IR and HOMA-B with multiple cardiometabolic disorders showed different patterns with varying magnitudes. The strongest joint associations were observed for diabetes, with low HOMA-B associated with high prevalence of diabetes regardless of HOMA-IR; joint associations with dyslipidemia and hypertension prevalence appeared to be additive and had moderate changing trends; and low HOMA-B was not associated with high prevalence of obesity or central obesity unless combined with high HOMA-IR. Conclusion: IR was associated with more prevalent cardiometabolic disorders than was β-cell dysfunction, and combinations of IR and β-cell dysfunction showed distinct relations with cardiometabolic risk patterns in Chinese adults.