›› 2018, Vol. 38 ›› Issue (8): 940-.doi: 10.3969/j.issn.1674-8115.2018.08.014

• Original article (Clinical research) • Previous Articles     Next Articles

Characteristic analysis of insulin secretion and sensitivity in pre-diabetes populations under new diagnostic criteria

HE Xing-xing, MA Xiao-jing, YING Ling-wen, ZHU Wei, GU Cheng-chen, TANG Jun-ling, WANG Yu-fei, BAO Yu-qian, ZHOU Jian   

  1. Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Department of Endocrinology and Metabolism, Shanghai Sixth Peoples Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
  • Online:2018-08-28 Published:2018-09-11
  • Supported by:
    Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Support，20161430

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Abstract: Objective · To investigate the characteristics of insulin secretion function and sensitivity and blood glucose disposition capacity in the pre-diabetes populations. Methods · A total of 1 317 subjects were enrolled in this study, including 382 with normal glucose tolerance (NGT) and 935 with pre-diabetes. All pre-diabetes populations were divided into seven subgroups according to the cut-off points of 2010 American Diabetes Association standards. Homeostasis model assessment (HOMA) was used to access baseline insulin secretion (HOMA-β) and insulin sensitivity (HOMA-IR). Insulin secretion and sensitivity after glucose load were evaluatedarea under curve (AUC) for insulin/AUC for glucose (AUCINS120/AUCGLU120) and insulin sensitivity index (ISI) calculated Cederholm formula, respectively. Disposition index (DI) was used to reflect blood glucose disposition capacity. Results · The most common type of pre-diabetes was impaired fasting glucose (IFG) combined with impaired glucose tolerance (IGT) and glycated hemoglobin A1c (HbA1c)5.7%-6.4%, followedisolated IGT, while the proportion of isolated IFG was the lowest. The insulin sensitivity of isolated HbA1c 5.7%-6.4% group was better than that of isolated IFG group, isolated IGT group, and IFG combined with IGT group (P<0.05). And its β-cell function was similar with the other subgroups. The DI value of isolated HbA1c 5.7%-6.4% group was about 1.5 times of that of isolated IGT group and IFG combined with IGT group (P0.000), which was similar with isolated IFG group. The function of β cell or insulin sensitivity in the pre-diabetes subjects with HbA1c 5.7%-6.4% was further damaged compared with the pre-diabetes people whose HbA1c were lower than 5.7%. Conclusion · Different types of pre-diabetes are significantly heterogeneous under new diagnostic criteria, and further prospective studies with a larger sample size are needed to clarify whether HbA1c 5.7%-6.4% is suias a diagnostic criteria for pre-diabetes in Chinese population.

Key words: pre-diabetes, pancreatic &, beta, -cell function, insulin sensitivity, glycated hemoglobinA1c (HbA1c), dispositionindex (DI)

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