Progression of insulin resistance: A link between risk factors and the incidence of diabetes

Wan-Chen Wu; Jung-Nan Wei; Szu-Chi Chen; Kang-Chih Fan; Chia-Hung Lin; Chung-Yi Yang; Mao-Shin Lin; Shyang-Rong Shih; Cyue-Huei Hua; Yenh-Chen Hsein; Lee-Ming Chuang; Hung-Yuan Li

doi:10.1016/j.diabres.2020.108050

Progression of insulin resistance: A link between risk factors and the incidence of diabetes

Diabetes Res Clin Pract. 2020 Mar:161:108050. doi: 10.1016/j.diabres.2020.108050. Epub 2020 Feb 5.

Authors

Affiliations

¹ Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
² Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
³ Division of Endocrinology and Metabolism, Department of Internal Medicine, Cardinal Tien Hospital, New Taipei City, Taiwan.
⁴ Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan.
⁵ Department of Medical Imaging, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine for International Students, I-Shou University, Kaohsiung, Taiwan; Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
⁶ Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁷ Division of Clinical Pathology, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
⁸ Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: larsli@ntuh.gov.tw.

PMID: 32035116
DOI: 10.1016/j.diabres.2020.108050

Abstract

Aims: Insulin resistance (IR) changes over time during the development of type 2 diabetes. Some reports showed that obesity was associated with progression of IR. However, no study has explored if change of IR predicts incident diabetes, and no study has investigated other factors associated with the change.

Methods: In this study, 1184 subjects without diabetes at baseline were enrolled in 2006-2016 with a median follow-up period of 4.5 years. Diabetes was diagnosed by oral glucose tolerance test and hemoglobin A1c, or if anti-diabetic agents were used. HOMA2-IR and ISI_0,120 were used to estimate IR.

Results: The annual changes of HOMA2-IR(ΔHOMA2-IR/year) and ISI_0,120(ΔISI_0,120/year) were associated with BMI, waist circumference(WC), glucose, HbA1c, triglyceride and HDL-cholesterol. Subjects with pre-diabetes or metabolic syndrome were associated with a more rapid increase of IR. ΔHOMA2-IR/year and ΔISI_0,120/year were correlated with annual changes of BMI and WC. The hazard ratios for ΔHOMA2-IR/year and ΔISI_0,120/year to predict incident diabetes were 1.39 (95% CI 1.22-1.59, p < 0.001) and 0.13 (95% CI 0.09-0.19, p < 0.001) in adjusted models, respectively.

Conclusions: Change of IR can be used as a surrogate marker of incident diabetes. The progression of IR is an important pathophysiologic link between risk factors and the incidence of diabetes.

Keywords: Change of Insulin resistance; HOMA2-IR; ISI(0,120); Incidence; Type 2 diabetes mellitus.

MeSH terms

Blood Glucose / metabolism*
Diabetes Mellitus, Type 2 / epidemiology
Diabetes Mellitus, Type 2 / etiology*
Disease Progression
Female
Humans
Incidence
Insulin Resistance / physiology*
Male
Middle Aged
Risk Factors

Substances

Blood Glucose