Comparison of Insulin Resistance and β-Cell Dysfunction Between the Young and the Elderly in Normal Glucose Tolerance and Prediabetes Population: A Prospective Study

Abstract

Insulin resistance and β-cell function are different between the young and elderly diabetes individuals, which are not well elaborated in the nondiabetic persons. The aims of this study were to compare insulin resistance and β-cell function between young and old adults from normal glucose tolerance (NGT) to prediabetes [which was subdivided into isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT), and a combination of both (IFG/IGT)], and compare the prevalence of diabetes mellitus (DM) in the above prediabetes subgroups between different age groups after 3 years. A total of 1 374 subjects aged below 40 or above 60 years old with NGT or prediabetes were finally included in this study. Insulin resistance and β-cell function from homeostasis model assessment (HOMA) and interactive, 24-variable homeostatic model of assessment (iHOMA2) were compared between different age groups. The rate of transition to diabetes between different age groups in all pre-diabetes subgroups was also compared. Compared with the old groups, young i-IFG and IFG/IGT groups exhibit higher log HOMA-IR and log HOMA2-S, whereas the young i-IGT groups experienced comparable log HOMA-IR and log HOMA2-S when compared with old i-IFG and IFG/IGT groups. Three prediabetes subgroups all had similar log HOMA-B and log HOMA2-B between different age groups. In addition, the prevalence of diabetes in young i-IFG was statistically higher than that in old i-IFG after 3 years. Age is negatively related to log HOMA2-B in both age groups. Considering an age-related deterioration of β-cell function, young i-IFG, young i-IGT, and young IFG/IGT all suffered a greater impairment in insulin secretion than the old groups. Young i-IFG and IFG/IGT have more severe insulin resistance than the old groups. In addition, young i-IFG characterized with a higher incidence of DM than the old i-IFG. These disparities highlight that the prevention to slow progression from prediabetes to type 2 diabetes should be additionally focused in young prediabetes individuals, especially young i-IFG.

The Effects of Folate Supplementation on Diabetes Biomarkers Among Patients with Metabolic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…We found that folate supplementation may result in significant decreases in insulin levels and HOMA-IR score, but did not affect FPG and HbA1c levels among patients with metabolic diseases. Previous studies have reported insulin resistance in patients with metabolic disorders such as obese, PCOS and diabetic patients [25][26][27][28][29]. Therapeutic lifestyle changes proposed at pursuing an acceptable control of risk factors of metabolic disorders, comprising hyperglycemia and insulin resistance, are limited by poor adherence and persistence [30,31].…”

Low total and free triiodothyronine levels are associated with insulin resistance in non-diabetic individuals

“… 25 found TSH was not associated with CRP; however, the authors indicated IR and obesity were important confounders. Young prediabetic individuals have been found to have greater impairment of insulin secretion than older prediabetic individuals 26 . The presence of advanced glycation end-products and nitric oxide has also been show to play a role in mediating IR and obesity 27 , 28 .…”

Altered Glucose Uptake in Muscle, Visceral Adipose Tissue, and Brain Predict Whole-Body Insulin Resistance and may Contribute to the Development of Type 2 Diabetes: A Combined PET/MR Study

“…Fourth, for feasibility reasons we only measured glucose uptake rates during hyperinsulinemia, and ideally future work should also address the fasting non-stimulated condition. Fifth, there are reports suggesting that age of prediabetes onset plays an important role in its progression [43]. The subjects in our study were age matched, but we did not take age of onset of prediabetes into consideration, this could be included in future research.…”