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Horm Metab Res 2017; 49(02): 135-141
DOI: 10.1055/s-0042-111325
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

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

G. Chen   *
1   Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou, China
,
L. Shi   *
1   Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou, China
,
L. Cai   *
1   Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou, China
,
W. Lin   *
1   Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou, China
,
H. Huang
1   Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou, China
,
J. Liang
1   Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou, China
,
L. Li
1   Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou, China
,
L. Lin
1   Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou, China
,
K. Tang
1   Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou, China
,
L. Chen
1   Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou, China
,
J. Lu
2   Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
,
Y. Bi
2   Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
,
W. Wang
2   Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
,
G. Ning
2   Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
,
J. Wen
1   Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou, China
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Weitere Informationen

Publikationsverlauf

received 06. Februar 2016

accepted 22. Juni 2016

Publikationsdatum:
26. Juli 2016 (online)

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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.

Key words

insulin resistance - β-cell function - prediabetic - young and old adult - normal glucose tolerance

* The first four authors contributed equally to the study


 

  • References

  • 1 Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001; 414: 782-787
    CrossrefPubMedGoogle Scholar
  • 2 Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Pre-diabetes: A high-risk state for developing diabetes. Lancet 2012; 379: 2279-2290
    CrossrefPubMedGoogle Scholar
  • 3 Szoke E, Shrayyef MZ, Messing S, Woerle HJ, van Haeften TW, Meyer C, Mitrakou A, Mitrakou A, Pimenta W, Gerich JE. Effect of aging on glucose homeostasis: accelerated deterioration of beta-cell function in individuals with impaired glucose tolerance. Diabetes Care 2008; 31: 539-543
    CrossrefPubMedGoogle Scholar
  • 4 Slentz CA, Tanner CJ, Bateman LA, Durheim MT, Huffman KM, Houmard JA, Kraus WE. Effects of exercise training intensity on pancreatic beta-cell function. Diabetes Care 2009; 32: 1807-1811
    CrossrefPubMedGoogle Scholar
  • 5 Hanefeld M, Koehler C, Fuecker K, Henkel E, Schaper F, Temelkova- Kurktschiev T. The impaired glucose tolerance for atherosclerosis and diabetes study: insulin secretion and insulin sensitivity pattern is different in isolated impaired glucose tolerance and impaired fasting glucose: the risk factor in impaired glucose tolerance for atherosclerosis and diabetes study. Diabetes Care 2003; 26: 868-874
    CrossrefPubMedGoogle Scholar
  • 6 Festa A, D’Agostino Jr R, Hanley AJ, Karter AJ, Saad MF, Haffner SM. Differences in insulin resistance in non-diabetic subjects with isolated impaired glucose tolerance or isolated impaired fasting glucose. Diabetes 2003; 53: 1549-1555
    PubMedGoogle Scholar
  • 7 American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2011; 34 (Suppl. 01) S62-S69
    CrossrefPubMedGoogle Scholar
  • 8 Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, Zinman B. American Diabetes Association; European Association for Study of Diabetes. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2009; 32: 193-203
    CrossrefPubMedGoogle Scholar
  • 9 Faerch K, Vaag A, Holst JJ, Hansen T, Jørgensen T, Borch-Johnsen K. Natural history of insulin sensitivity and insulin secretion in the progression from normal glucose tolerance to impaired fasting glycemia and impaired glucose tolerance: the inter99 study. Diabetes Care 2009; 32: 3439-444
    PubMedGoogle Scholar
  • 10 Abdul-Ghani MA, Tripathy D, DeFronzo RA. Contributions of beta-cell dysfunction and insulin resistance to the pathogenesis of impaired glucose tolerance and impaired fasting glucose. Diabetes Care 2006; 29: 1130-1139
    CrossrefPubMedGoogle Scholar
  • 11 Meneilly GS, Elahi D. Metabolic alterations in middle-aged and elderly lean patients with type 2 diabetes. Diabetes Care 2005; 28: 1498-1489
    CrossrefPubMedGoogle Scholar
  • 12 Leslie RD, Delli Castelli M. Perspectives in diabetes age-dependent influences on the origins of autoimmune diabetes evidence and implications. Diabetes 2004; 53: 3033-3040
    CrossrefPubMedGoogle Scholar
  • 13 Niña G. Reaction Study Group. Risk evaluation of cancers in Chinese diabetic individuals: a longitudinal (REACTION) study. J Diabetes 2012; 4: 172-173
    CrossrefPubMedGoogle Scholar
  • 14 Bi Y, Lu J, Wang W, Mu Y, Zhao J, Liu C, Chen L, Shi L, Li Q, Wan Q, Wu S, Yang T, Yan L, Liu Y, Wang G, Luo Z, Tang X, Chen G, Huo Y, Gao Z, Su Q, Ye Z, Wang Y, Qin G, Deng H, Yu X, Shen F, Chen L, Zhao L, Zhang J, Sun J, Dai M, Xu M, Xu Y, Chen Y, Lai S, Bloomgarden ZT, Li D, Ning G. Cohort profile: Risk evaluation of cancers in Chinese diabetic individuals: a longitudinal (REACTION) study. J Diabetes 2014; 6: 147-157
    CrossrefPubMedGoogle Scholar
  • 15 American Diabetes Association. Standards of Medical Care in Diabetes 2015. Diabetes Care 2015; 38 (Suppl. 01) S1-S93
    Google Scholar
  • 16 Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, Jones DW, Materson BJ, Oparil S, Wright Jr JT, Roccella EJ. National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection,Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289: 2560-2572
    CrossrefPubMedGoogle Scholar
  • 17 Otten J, Ahrén B, Olsson T. Surrogate measures of insulin sensitivity vs the hyperinsulinaemic-euglycaemic clamp: a meta-analysis. Diabetologia 2014; 57: 1781-1788
    CrossrefPubMedGoogle Scholar
  • 18 Solomon TP, Malin SK, Karstoft K, Knudsen SH, Haus JM, Laye MJ, Pedersen M, Pedersen BK, Kirwan JP. Determining pancreatic β-cell compensation for changing insulin sensitivity using an oral glucose tolerance test. Am J Physiol Endocrinol Metab 2014; 307: E822-E829
    CrossrefPubMedGoogle Scholar
  • 19 Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-419
    Google Scholar
  • 20 Hill 1 NR, Levy JC, Matthews DR. Expansion of the homeostasis model assessment of beta-cell function and insulin resistance to enable clinical trial outcome modeling through the interactive adjustment of physiology and treatment effects: iHOMA2. Diabetes Care 2013; 36: 2324-2330
    CrossrefPubMedGoogle Scholar
  • 21 Levy JC, Matthews DR, Hermans MP. Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care 1998; 21: 2191-2192
    CrossrefPubMedGoogle Scholar
  • 22 Yates AP, Laing I. Age-related increase in haemoglobinA1c and fasting plasma glucose is accompanied by a decrease in β cell function without change in insulin sensitivity: evidence from a cross-sectional study of hospital personnel. Diabetes Med 2002; 19: 254-258
    CrossrefPubMedGoogle Scholar
  • 23 Ning F, Qiao Q, Tuomilehto J, Hammar N, Ho SY, Soederberg S, Zimmet PZ, Shaw JE, Nakagami T, Mohan V, Ramachandran A, Lam TH, Anderson SW, Janus ED, Boyko EJ, Fujimoto WY, Pang ZC. Does abnormal insulin action or insulin secretion explain increase in prevalence of impaired glucose metabolism with age in populations of different ethnicities?. Diabetes Metab Res Rev 2010; 26: 245-253
    CrossrefPubMedGoogle Scholar
  • 24 O’Shaughnessy IM, Kasdorf GM, Hoffmann RG, Kalkhoff RK. Does aging intensify the insulin resistance of human obesity?. J Clin Endocrinol Metab 1992; 74: 1075-1081
    CrossrefPubMedGoogle Scholar
  • 25 Karakelides H, Irving BA, Short KR, O’Brien P, Nair KS. Age, obesity, and sex effects on insulin sensitivity and skeletal muscle mitochondrial function. Diabetes 2010; 59: 89-97
    CrossrefPubMedGoogle Scholar
  • 26 Xiao J, Weng J, Ji L, Jia W, Lu J, Shan Z, Liu J, Tian H, Ji Q, Yang Z, Yang W. Worse Pancreatic β-cell function and better insulin sensitivity in older Chinese without diabetes. J Gerontol A Biol 2014; 69: 463-470
    CrossrefPubMedGoogle Scholar
  • 27 The DPP Research Group. Role of insulin secretion and sensitivity in the evolution of type 2 diabetes in the Diabetes Prevention Program: effect of lifestyle intervention and metformin. J Gerontology 2006; 61: 1075-1081
    PubMedGoogle Scholar
  • 28 Chiu KC, Lee NP, Cohan P, Chuang LM. Beta cell function declines with age in glucose tolerant Caucasians. Clin Endocrinol (Oxf) 2000; 53: 569-575
    CrossrefPubMedGoogle Scholar
  • 29 Iozzo P, Beck-Nielsen H, Laakso M, Smith U, Yki-Jarvinen H, Ferrannini E. Independent influence of age on basal insulin secretion in nondiabetic humans. European Group for the Study of Insulin Resistance. J Clin Endocrinol Metab 1999; 84: 863-868
    CrossrefPubMedGoogle Scholar
  • 30 Biggs ML, Mukamal KJ, Luchsinger JA, Ix JH, Carnethon MR, Newman AB, de Boer IH, Strotmeyer ES, Mozaffarian D, Siscovick DS. Association between adiposity in midlife and older age and risk of diabetes in older adults. JAMA 2010; 303: 2504-2512
    CrossrefPubMedGoogle Scholar
  • 31 Scheen AJ. Diabetes mellitus in the elderly: insulin resistance and/or impaired insulin secretion. Diabetes Metab. 2005 31. 5S27-5S34
    PubMedGoogle Scholar
  • 32 Lacerte G, Langlois MF, Doyon M, Brown C, Carpentier AC, Hivert MF. Different impact of changes in adiposity distribution on insulin resistance and adiponectin variation over 4 years in normal weight young adults. Horm Metab Res 2014; 46: 354-359
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 33 Horie A, Tokuyama Y, Ishizuka T, Suzuki Y, Marumo K, Oshikiri K, Ide K, Sunaga M, Kanatsuka A. The dipeptidyl peptidase-4 inhibitor vildagliptin has the capacity to repair β-cell dysfunction and insulin resistance. Horm Metab Res 2014; 46: 814-818
    Artikel in Thieme ConnectPubMedGoogle Scholar