Impaired β-cell function and insulin sensitivity in Japanese subjects with normal glucose tolerance

Abstract

The development of type 2 diabetes mellitus is characterized by both impaired beta-cell function and increasing insulin resistance. To clarify the roles of them in developing type 2 diabetes, we evaluated insulin resistance by HOMA-IR and insulin secretion by HOMA beta-cell in 453 Japanese subjects whose fasting plasma glucose (FPG) and HbA(1c) levels were within normal range. HOMA beta-cell was found to decrease in the over 30 years groups, while HOMA-IR increased with body mass index (BMI). To analyze the reserve capacity of insulin secretion and insulin sensitivity, the 67 of them, who underwent a standard oral glucose tolerance test and were diagnosed with normal glucose tolerance (NGT), were divided into four degrees of BMI age-adjusted to 50 years. They were compared for insulinogenic index and ISI composite proposed by Matsuda and DeFronzo across the range of BMI. ISI composite was significantly less in the highest BMI group, while insulin secretion did not increase in the higher BMI groups. The subjects with higher BMI had remarkably lower insulinogenic indices than those with lower BMI. These data suggest that insulin secretory reserve is insufficient to compensate for increased insulin resistance in Japanese people with NGT at about 50 years of age.

Índice HOMA (homeostasis model assessment) na prática clínica: uma revisão

“…Quatro artigos (8%) tratam de abordagens relativas à definição de valores de referência para o índice HOMA; o mais recente envolve 6.511 americanos (1,13,46,75) .…”

“…Tais técnicas vêm servindo ao entendimento dos mecanismos regulatórios envolvidos na homeostase da glicose e na patogênese do diabetes tipo 2 (46,56,86) , à avaliação de risco e predição do desenvolvimento de diabetes tipo 2 (DM2) em estudos epidemiológicos (23,26) , para avaliação do curso clinicoterapêutico do diabetes (39,76,82) , para medida da RI associada à síndrome dos ovários policísticos (3,4,83,84) ; bem como para a determinação da RI e da BcC, base para trabalhos acerca da patogenia genético-molecular da RI e dos distúrbios da tolerância à glicose (7,34) .…”

Prevalence of diabetes mellitus and glucose metabolism disorders in the first degree relatives of type 2 diabetic patients

“…HOMA ISI values calculated by using OGTT data show the insulin sensitivity of tissues (9). Differences among HOMA ISI values of the groups show that insulin sensitivity of tissues is decreased in the fi rst degree relatives (p<0.005 F; 11.38 One Way -ANOVA) (Tab.…”

“…Criteria for the diagnosis of diabetes, impaired fasting glucose, and impaired glucose tolerance (IGT) were made according to ADA criteria (7). HOMA IR , HOMA ISI , AUC Glucose values were also calculated with data obtained from the OGTT results (8,9,10 …”

Total Management of Diabetic Foot Ulcerations - Kobe Classification as a New Classification of Diabetic Foot Wounds

“…6 Kadowaki, et al reported that early insulin response was an independent predictor for diabetes. 7 In Japanese men with normal glucose tolerance, even a small increase in BMI produced a decrease in beta cell function disproportionate to that in insulin sensitivity, 8 indicating that there are inherent differences between Asian and Caucasian populations. Furthermore, Asia …”