Insulin resistance, beta cell dysfunction and visceral adiposity as predictors of incident diabetes: the Insulin Resistance Atherosclerosis Study (IRAS) Family study.
Insulin resistance, beta cell dysfunction and visceral adiposity as predictors of incident diabetes: the Insulin Resistance Atherosclerosis Study (IRAS) Family study.
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DOI：
10.1007/s00125-009-1464-y
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发表时间：
2009-10
期刊：
影响因子：
8.2
通讯作者：
Haffner, S. M.
中科院分区：
文献类型：
--
作者：
Hanley, A. J. G.;Wagenknecht, L. E.;Norris, J. M.;Bryer-Ash, M.;Chen, Y. I.;Anderson, A. M.;Bergman, R.;Haffner, S. M.
关键词：
中心性肥胖、胰岛素抵抗和 β 细胞功能障碍是 2 型糖尿病发生的独立危险因素，尽管很少有研究对这些疾病进行详细测量。我们的目的是研究直接测量的内脏和皮下脂肪组织 (VAT、SAT)、胰岛素敏感性 (SI) 和急性胰岛素反应 (AIR) 与 2 型糖尿病的关联。胰岛素抵抗动脉粥样硬化研究 (IRAS) 家庭研究的参与者为 1,230 名西班牙裔美国人和非裔美国人，他们在基线（2000-2002 年）时没有患 2 型糖尿病。 SI 和 AIR 是根据频繁采样的 IVGTT 并通过最少的模型分析确定的。 VAT 和 SAT 通过计算机断层扫描确定。空腹血糖受损和 2 型糖尿病是根据美国糖尿病协会标准定义的。 5 年后，90 名参与者被诊断出患有 2 型糖尿病。调整年龄、性别、种族、中心、空腹血糖受损、三酰甘油、HDL-胆固醇和收缩压后，SI和AIR均与2型糖尿病呈负相关（SI，OR 0.53，95% CI 0.39–0.73；AIR，OR 0.22，95% CI 0.14–0.34/SD；均p<0.001）， VAT 和 SAT 均与 2 型糖尿病呈正相关（VAT，OR 1.68，95% CI 1.22-2.33；SAT，OR 1.49，95% CI 1.13-1.99；均 p<0.01）。在包含所有四个因素的模型中，SI 和 AIR（SI，OR 0.55，95% CI 0.37-0.80；AIR，OR 0.21，95% CI 0.13-0.33；均 p<0.01）是 2 型糖尿病的显着预测因子，尽管与 VAT 和 SAT 的关联不再显着。显着的性别×增值税交互作用表明，女性增值税与 2 型糖尿病的关联性强于男性。胰岛素抵抗、β 细胞功能障碍和 VAT 可以预测 2 型糖尿病的发生，有证据表明 VAT 与女性 2 型糖尿病的关联性更强。
Central obesity, insulin resistance and beta cell dysfunction are independent risk factors for incident type 2 diabetes, although few studies have used detailed measures of these disorders. Our objective was to study the association of directly measured visceral and subcutaneous adipose tissue (VAT, SAT), insulin sensitivity (SI) and the acute insulin response (AIR) with incident type 2 diabetes. Participants were 1,230 Hispanic-Americans and African-Americans in the Insulin Resistance Atherosclerosis Study (IRAS) Family Study who were free of type 2 diabetes at baseline (2000–2002). SI and AIR were determined from frequently sampled IVGTTs with minimal model analysis. VAT and SAT were determined by computed tomography. Impaired fasting glucose and type 2 diabetes were defined according to American Diabetes Association criteria. Incident type 2 diabetes was diagnosed in 90 participants after 5 years. After adjustment for age, sex, ethnicity, centre, impaired fasting glucose, triacylglycerol, HDL-cholesterol and systolic BP, both SI and AIR were inversely associated with type 2 diabetes (SI, OR 0.53, 95% CI 0.39–0.73; AIR, OR 0.22, 95% CI 0.14–0.34 per SD; both p<0.001), while both VAT and SAT were positively associated with type 2 diabetes (VAT, OR 1.68, 95% CI 1.22–2.33; SAT, OR 1.49, 95% CI 1.13–1.99; both p<0.01). In a model including all four factors, SI and AIR (SI, OR 0.55, 95% CI 0.37–0.80; AIR, OR 0.21, 95% CI 0.13–0.33; both p<0.01) were significant predictors of type 2 diabetes, although associations with VAT and SAT were no longer significant. A significant sex × VAT interaction indicated a stronger association of VAT with type 2 diabetes in women than in men. Insulin resistance, beta cell dysfunction and VAT predicted incident type 2 diabetes, with evidence of a stronger association of VAT with type 2 diabetes among women.
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