Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetes

Jiunn Diann Lin, Chang Hsun Hseih, Wei Cheng Lian, Dee Pei, Yao Jen Liang, Yen Lin Chen

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)203-209
Number of pages7
JournalAnnals of Saudi Medicine
Volume36
Issue number3
DOIs
Publication statusPublished - May 1 2016

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Type 2 Diabetes Mellitus
Diabetes Mellitus
Insulin
Pharmaceutical Preparations
Body Mass Index
Glucose
Insulin Resistance
Multivariate Analysis
Glucose Tolerance Test
Taiwan
ROC Curve
HDL Cholesterol
Fasting
Triglycerides
Cohort Studies
Obesity
Cross-Sectional Studies
Regression Analysis
Sensitivity and Specificity

ASJC Scopus subject areas

  • Medicine(all)

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Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetes. / Lin, Jiunn Diann; Hseih, Chang Hsun; Lian, Wei Cheng; Pei, Dee; Liang, Yao Jen; Chen, Yen Lin.

In: Annals of Saudi Medicine, Vol. 36, No. 3, 01.05.2016, p. 203-209.

Research output: Contribution to journalArticle

Lin, Jiunn Diann ; Hseih, Chang Hsun ; Lian, Wei Cheng ; Pei, Dee ; Liang, Yao Jen ; Chen, Yen Lin. / Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetes. In: Annals of Saudi Medicine. 2016 ; Vol. 36, No. 3. pp. 203-209.
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abstract = "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.",
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T1 - Metabolic syndrome in drug-naïve Chinese patients with insulin-sensitive and insulin-resistant type 2 diabetes

AU - Lin, Jiunn Diann

AU - Hseih, Chang Hsun

AU - Lian, Wei Cheng

AU - Pei, Dee

AU - Liang, Yao Jen

AU - Chen, Yen Lin

PY - 2016/5/1

Y1 - 2016/5/1

N2 - 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.

AB - 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.

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