Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetes
BACKGROUND: Type 2 diabetes mellitus (T2DM) is characterized by impaired insulin sensitivity (Si) and insulin secretion. Previous studies may have underestimated differences in the incidence of risk factors in insulin-sensitive diabetes mellitus (IS-DM) and insultin-resistant diabetes mellitus (IR-D...
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| Format: | Article |
| Language: | English |
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King Faisal Specialist Hospital and Research Centre
2016-05-01
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| Series: | Annals of Saudi Medicine |
| Online Access: | https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2016.203 |
| _version_ | 1818874501923864576 |
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| author | Jiunn-Diann Lin Chang-Hsun Hseih Wei-Cheng Lian Dee Pei Yao-Jen Liang Yen-Lin Chen |
| author_facet | Jiunn-Diann Lin Chang-Hsun Hseih Wei-Cheng Lian Dee Pei Yao-Jen Liang Yen-Lin Chen |
| author_sort | Jiunn-Diann Lin |
| collection | DOAJ |
| description | BACKGROUND: Type 2 diabetes mellitus (T2DM) is characterized by impaired insulin sensitivity (Si) and insulin secretion. Previous studies may have underestimated differences in the incidence of risk factors in insulin-sensitive diabetes mellitus (IS-DM) and insultin-resistant diabetes mellitus (IR-DM) patients and have not been conducted in the Chinese population. OBJECTIVES: We explored differences in metabolic risk factors between Chinese patients with newly diagnosed, insulin-resistant (IR) and insulin-sensitive (IS) T2DM. DESIGN: Cross-sectional study. SETTING: Cardinal Tien Hospital, Taiwan in 2011. METHODS: All participants received a frequently sampled intravenous glucose tolerance test. The acute insulin response after a glucose load (AIRg), Si, disposition index (DI), and glucose effectiveness (GE) were determined. Using the median Si value from 90 people without diabetes as a cutoff (1.19 ×10-4 mU/L/min), patients were divided into two groups, IS-DM and IR-DM. Multivariate regression analysis was used to examine the independent influence of MetS components on Si and AIRg. MAIN OUTCOME MEASURE(S): Insulin sensitivity. RESULTS: We enrolled 122 participants. In addition to higher probabilities of having MetS, IR-DM patients had a significantly higher body mass index (BMI), AIRg, and GE but a lower DI than IS-DM patients. Si correlated with BMI and triglycerides, and AIRg correlated with BMI and high-density lipoprotein cholesterol. BMI was the only component related to Si in the multivariate analysis. Furthermore, the AIRg was associated with BMI and fasting plasma glucose. Because BMI was the most critical factor, a cutoff value (25.0 kg/m2) was obtained from the receiver operating characteristic curve for predicting IR-DM. It showed a sensitivity and specificity of 60.8% and 60.9%, respectively. CONCLUSIONS: IR-DM patients had more MetS components than IS-DM patients. In Chinese patients obesity is the most critical factor for discriminating IR-DM from IS-DM. Patients with a BMI higher than 25 kg/m2 were prone to develop IR-DM. LIMITATIONS: The size of our study cohort was relatively small, which may weaken the statistical power of the study. |
| first_indexed | 2024-12-19T13:11:37Z |
| format | Article |
| id | doaj.art-b282933439c2474a987962b3e7f12c36 |
| institution | Directory Open Access Journal |
| issn | 0256-4947 0975-4466 |
| language | English |
| last_indexed | 2024-12-19T13:11:37Z |
| publishDate | 2016-05-01 |
| publisher | King Faisal Specialist Hospital and Research Centre |
| record_format | Article |
| series | Annals of Saudi Medicine |
| spelling | doaj.art-b282933439c2474a987962b3e7f12c362022-12-21T20:19:54ZengKing Faisal Specialist Hospital and Research CentreAnnals of Saudi Medicine0256-49470975-44662016-05-0136320320910.5144/0256-4947.2016.203asm-3-203Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetesJiunn-Diann Lin0Chang-Hsun Hseih1Wei-Cheng Lian2Dee Pei3Yao-Jen Liang4Yen-Lin Chen5From the Division of Endocrinology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University; Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, TaiwanFrom the Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei, TaiwanFrom the Division of Endocrinology and Metabolism, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital and College of Medicine, Tzu Chi University, Hualien City, TaiwanFrom the Division of Endocrinology and Metabolism, Department of Internal Medicine, Cardinal Tien Hospital, Medical School, Catholic Fu Jen University, New Taipei City, TaiwanFrom the Department of Life Science, Graduate Institute of Applied Science and Engineering, College of Science and Engineering, Fu Jen Catholic University, Taipei, TaiwanFrom the Department of Pathology, Cardinal Tien Hospital, Medical School, Fu Jen Catholic University, New Taipei City, TaiwanBACKGROUND: Type 2 diabetes mellitus (T2DM) is characterized by impaired insulin sensitivity (Si) and insulin secretion. Previous studies may have underestimated differences in the incidence of risk factors in insulin-sensitive diabetes mellitus (IS-DM) and insultin-resistant diabetes mellitus (IR-DM) patients and have not been conducted in the Chinese population. OBJECTIVES: We explored differences in metabolic risk factors between Chinese patients with newly diagnosed, insulin-resistant (IR) and insulin-sensitive (IS) T2DM. DESIGN: Cross-sectional study. SETTING: Cardinal Tien Hospital, Taiwan in 2011. METHODS: All participants received a frequently sampled intravenous glucose tolerance test. The acute insulin response after a glucose load (AIRg), Si, disposition index (DI), and glucose effectiveness (GE) were determined. Using the median Si value from 90 people without diabetes as a cutoff (1.19 ×10-4 mU/L/min), patients were divided into two groups, IS-DM and IR-DM. Multivariate regression analysis was used to examine the independent influence of MetS components on Si and AIRg. MAIN OUTCOME MEASURE(S): Insulin sensitivity. RESULTS: We enrolled 122 participants. In addition to higher probabilities of having MetS, IR-DM patients had a significantly higher body mass index (BMI), AIRg, and GE but a lower DI than IS-DM patients. Si correlated with BMI and triglycerides, and AIRg correlated with BMI and high-density lipoprotein cholesterol. BMI was the only component related to Si in the multivariate analysis. Furthermore, the AIRg was associated with BMI and fasting plasma glucose. Because BMI was the most critical factor, a cutoff value (25.0 kg/m2) was obtained from the receiver operating characteristic curve for predicting IR-DM. It showed a sensitivity and specificity of 60.8% and 60.9%, respectively. CONCLUSIONS: IR-DM patients had more MetS components than IS-DM patients. In Chinese patients obesity is the most critical factor for discriminating IR-DM from IS-DM. Patients with a BMI higher than 25 kg/m2 were prone to develop IR-DM. LIMITATIONS: The size of our study cohort was relatively small, which may weaken the statistical power of the study.https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2016.203 |
| spellingShingle | Jiunn-Diann Lin Chang-Hsun Hseih Wei-Cheng Lian Dee Pei Yao-Jen Liang Yen-Lin Chen Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetes Annals of Saudi Medicine |
| title | Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetes |
| title_full | Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetes |
| title_fullStr | Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetes |
| title_full_unstemmed | Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetes |
| title_short | Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetes |
| title_sort | metabolic syndrome in drug naive chinese patients with insulin sensitive and insulin resistant type 2 diabetes |
| url | https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2016.203 |
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