Clinical Significance of the Maximum Body Mass Index Before Onset of Type 2 Diabetes for Predicting Beta-Cell Function
Clinical Significance of the Maximum Body Mass Index Before Onset of Type 2 Diabetes for Predicting Beta-Cell Function
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DOI：
10.1210/jendso/bvz023
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发表时间：
2020-04-01
影响因子：
4.1
通讯作者：
Shimomura, Iichiro
中科院分区：
文献类型：
--
作者：
Ozawa, Harutoshi;Fukui, Kenji;Shimomura, Iichiro
目的：探讨2型糖尿病(MBBO)患者发病前最大体重指数(BMI)对预测胰岛β细胞功能的临床意义。在连续入院的1304名2型糖尿病患者中，我们招募了410名符合本研究标准的患者。用多元线性回归分析反映胰岛β细胞功能的C-肽指数(CPI)与MBBO、病程等临床参数的相关性。结果：调整年龄、性别、糖化血红蛋白、病程后，MBBO与CPI独立相关。当我们按MBBO将受试者分为三个亚组(MBBO+lt；25 kg/m(2)；25 kg/m(2)=30 kg/m(2))时，CPI与糖尿病病程呈负相关，而基于糖尿病病程的CPI在三个MBBO亚组之间没有差异。相反，入院时体重指数为25 kg/m(2)组的CPI下降率高于入院时体重指数为25 kg/m(2)组。结论：MBBO可能是与胰岛β细胞功能相关的独立因素，可在确诊时预测胰岛素分泌能力，但似乎不影响确诊后胰岛素分泌能力下降的速度。无论MBBO如何，在确诊后的治疗过程中，通过降低患者的BMI来保护β细胞功能是很重要的。(C)内分泌学会2020年。
Objective: This study aimed to clarify the clinical significance of the maximum body mass index (BMI) before the onset of type 2 diabetes (MBBO) for predicting pancreatic beta-cell function.Methods: This was a cross-sectional observational study. Of 1304 consecutively admitted patients with type 2 diabetes, we enrolled 410 patients satisfying the criteria in this study. The correlations between the C-peptide index (CPI), which is one of the parameters that reflects beta-cell function, and various clinical parameters, including MBBO and duration of diabetes, were analyzed in multiple linear regression analyses.Results: The analyses revealed that MBBO was correlated with CPI independently after adjustment for age, sex, HbA1c, and duration of diabetes. When we divided the subjects into three subgroups by MBBO (MBBO < 25 kg/m(2); 25 kg/m(2) = 30 kg/m(2)), CPI was negatively correlated with duration of diabetes in each subgroup, while the rates of CPI based on the duration of diabetes were not different among the three MBBO subgroups. In contrast, the declining rates of CPI were higher in the BMI >= 25 kg/m(2) group on admission than in the BMI < 25 kg/m(2) group on admission.Conclusions: MBBO may be an independent factor correlating with beta-cell function and may predict insulin secretion capacity at diagnosis, but it does not seem to affect the rate of decline in insulin secretion capacity after diagnosis. It is important to preserve beta-cell function by decreasing a patient's BMI during treatment after diagnosis regardless of MBBO. (C) Endocrine Society 2020.