The correlation between proinsulin, true insulin, proinsulin: True insulin ratio, 25(OH) D3, waist circumference and risk of prediabetes in Hainan Han adults

Huibiao Quan; Tuanyu Fang; Leweihua Lin; Lu Lin; Qianying Ou; Huachuan Zhang; Kaining Chen; Zhiguang Zhou

doi:10.1371/journal.pone.0238095

The correlation between proinsulin, true insulin, proinsulin: True insulin ratio, 25(OH) D3, waist circumference and risk of prediabetes in Hainan Han adults

PLoS One. 2020 Sep 3;15(9):e0238095. doi: 10.1371/journal.pone.0238095. eCollection 2020.

Authors

Huibiao Quan^{1

2}, Tuanyu Fang², Leweihua Lin², Lu Lin², Qianying Ou², Huachuan Zhang², Kaining Chen², Zhiguang Zhou¹

Affiliations

¹ Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
² Department of Endocrinology, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China.

Abstract

Purpose: Diabetes mellitus is a kind of highly prevalent chronic disease in the world. The intervention measures on the risk factors of prediabetes contribute to control and reduce the occurrence of diabetes. This study aimed to investigate the correlation between proinsulin (PI), true insulin (TI), PI/TI, 25(OH) D3, waist circumference (WC), and risk of prediabetes.

Methods: In this cross-sectional study, 1662 subjects including 615 prediabetes and 1047 non-prediabetes were recruited. Spearman's correlation analysis was used to explore the association of PI, TI, PI/TI, 25(OH) D3, and waist circumference with prediabetes. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by logistic regression. Receiver-Operator Characteristic (ROC) curve was used to evaluate the risk of prediabetes.

Results: Our study showed that FPI, 2hPI, FTI, 2hTI, FPI/FTI, and WC could enhance the risk of prediabetes (OR 1.034; OR 1.007; OR 1.005; OR 1.002; OR 3.577, OR 1.053, respectively; all p< 0.001). Stratified analyses indicated that FPI/FTI associated with an increased risk of prediabetes in men (OR 2.080, p = 0.042). FTI have a weak association with prediabetes risk in men and women (OR 0.987, p = 0.001; OR 0.994, p = 0.004, respectively). 2hPI could decrease prediabetes in women (OR 0.995, p = 0.037). Interesting, the sensitivity (86.0%) and AUC (0.942, p< 0.001) of combination (FPI+FTI+2hPI+2hTI+25(OH) D3+WC) were higher than the diagnostic value of these alone diagnoses. The optimal cutoff point of FPI, FTI, 2hPI, 2hTI, 25(OH) D3, and WC for indicating prediabetes were 15.5 mU/l, 66.5 mU/l, 71.5 mU/l, 460.5 mU/l, 35.5 ng/ml, and 80.5 cm, respectively. What's more, the combination (FPI+FTI+2hPI+2hTI+25(OH) D3+WC) significantly improved the diagnostic value beyond the alone diagnoses of prediabetes in men and women (AUC 0.771; AUC 0.760, respectively).

Conclusion: The FPI, 2hPI, FTI, 2hTI, FPI/FTI, and WC significantly associated with an increased risk of prediabetes. The combination of FPI, FTI, 2hPI, 2hTI, 25(OH) D3, and WC might be used as diagnostic indicators for prediabetes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Area Under Curve
Calcifediol / blood*
China
Cross-Sectional Studies
Female
Glucose Tolerance Test
Humans
Insulin / blood*
Insulin, Regular, Human
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Prediabetic State / diagnosis*
Proinsulin / blood*
ROC Curve
Risk Factors
Waist Circumference

Substances

Insulin
Insulin, Regular, Human
Proinsulin
Calcifediol

Grants and funding

the National Key R&D Program of China (2016YFC1305000, 2016YFC1305001 and 2018YFC1315603), the National Natural Science Foundation of China (81820108007) and Hainan Provincial Key Research and Development Project (ZDYF2018130).