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.
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
. Characteristic analysis of insulin secretion and sensitivity in pre-diabetes populations under new diagnostic criteria[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2018
, 38(8)
: 940
.
DOI: 10.3969/j.issn.1674-8115.2018.08.014