Impact of impaired insulin secretion and insulin resistance on the incidence of type 2 diabetes mellitus in a Japanese population: the Saku study
Impact of impaired insulin secretion and insulin resistance on the incidence of type 2 diabetes mellitus in a Japanese population: the Saku study
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DOI：
10.1007/s00125-013-2932-y
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发表时间：
2013-08-01
期刊：
影响因子：
8.2
通讯作者：
Watanabe, Shaw
中科院分区：
文献类型：
--
作者：
Morimoto, Akiko;Tatsumi, Yukako;Watanabe, Shaw
为了评估胰岛素分泌受损（IIS）和胰岛素抵抗（IR）对日本人群2型糖尿病发病率的影响，这项为期4年的队列研究纳入了3，059名年龄在30-69岁基线时无糖尿病的参与者，他们于2006年4月至2007年3月在佐久中央医院接受了全面的医学检查。根据胰岛素生成指数和HOMA-IR值，将受试者按照日本糖尿病学会的标准分为4类：正常、单纯IIS（i-IIS）、单纯IR（i-IR）和IIS + IR。随访至2011年3月。2型糖尿病的发病率是根据空腹和负荷后2小时的血糖浓度以及接受糖尿病药物治疗来确定的。（50.7%）被归类为正常，900（29.4%）i-IIS，505例（16.5%）i-IR，和104在10，553人年的随访中，219人发展为2型糖尿病，其中126人（57.5%）在基线时患有i-IIS。相对于正常组，i-IIS、i-IR和IIS + IR组2型糖尿病的多变量校正HR分别为8.27（95% CI 5.33，12.83）、4.90（95% CI 2.94，8.17）和16.93（95% CI 9.80，29.25）。i-IIS、i-IR和IIS + IR导致2型糖尿病发病的人群归因分数为50.6%（95% CI 46.7%，53.0%），14.2%（95%CI 11.8%，15.6%）和12.9%（95%CI 12.3%，13.2%）。与IR相比，IIS对日本人群2型糖尿病发病率的影响更大。
To assess the impact of impaired insulin secretion (IIS) and insulin resistance (IR) on type 2 diabetes incidence in a Japanese population.This 4 year cohort study included 3,059 participants aged 30-69 without diabetes at baseline who underwent comprehensive medical check-ups between April 2006 and March 2007 at Saku Central Hospital. Based on their insulinogenic index and HOMA-IR values, participants were classified by the criteria of the Japan Diabetes Society into four categories: normal; isolated IIS (i-IIS); isolated IR (i-IR); and IIS plus IR. They were followed up until March 2011. The incidence of type 2 diabetes was determined from fasting and 2 h post-load plasma glucose concentrations and from receiving medical treatment for diabetes.At baseline, 1,550 individuals (50.7%) were classified as normal, 900 (29.4%) i-IIS, 505 (16.5%) i-IR, and 104 (3.4%) IIS plus IR. During 10,553 person-years of follow-up, 219 individuals developed type 2 diabetes, with 126 (57.5%) having i-IIS at baseline. Relative to the normal group, the multivariable-adjusted HRs for type 2 diabetes in the i-IIS, i-IR and IIS plus IR groups were 8.27 (95% CI 5.33, 12.83), 4.90 (95% CI 2.94, 8.17) and 16.93 (95% CI 9.80, 29.25), respectively. The population-attributable fractions of type 2 diabetes onset due to i-IIS, i-IR, and IIS plus IR were 50.6% (95% CI 46.7%, 53.0%), 14.2% (95% CI 11.8%, 15.6%) and 12.9% (95% CI 12.3%, 13.2%), respectively.Compared with IR, IIS had a greater impact on the incidence of type 2 diabetes in a Japanese population.