The association of unintentional changes in weight, body composition, and homeostasis model assessment index with glycemic progression in non-diabetic healthy subjects

• Published in: Diabetes & metabolism journal 2011, 35(2), 124, pp.138-148
• Main Authors: Rhee, Eun-Jung, Choi, Ji-Hun, Yoo, Seung-Hyun, Bae, Ji-Cheol, Kim, Won-Jun, Choi, Eun-Suk, Park, Se Eun, Park, Cheol-Young, Park, Seok Won, Oh, Ki-Won, Park, Sung-Woo, Kim, Sun-Woo, Lee, Won-Young
• Format: Article
• Language: English
• Subjects: Glycemic progression; Original; Prediabetes; Skeletal muscle index; Visceral obesity; Weight change; 내과학
• ISSN: 2233-6079; 2233-6087
• DOI: 10.4093/dmj.2011.35.2.138

We performed a retrospective longitudinal study on the effects of changes in weight, body composition, and homeostasis model assessment (HOMA) indices on glycemic progression in subjects without diabetes during a four-year follow-up period in a community cohort without intentional intervention. From 28,440 non-diabetic subjects who participated in a medical check-up program in 2004, data on anthropometric and metabolic parameters were obtained after four years in 2008. Body composition analyses were performed with a bioelectrical impedance analyzer. Skeletal muscle index (SMI, %) was calculated with lean mass/weight×100. Subjects were divided into three groups according to weight change status in four years: weight loss (≤-5.0%), stable weight (-5.0 to 5.0%), weight gain (≥5.0%). Progressors were defined as the subjects who progressed to impaired fasting glucose or diabetes. Progressors showed worse baseline metabolic profiles compared with non-progressors. In logistic regression analyses, the increase in changes of HOMA-insulin resistance (HOMA-IR) in four years presented higher odds ratios for glycemic progression compared with other changes during that period. Among the components of body composition, a change in waist-hip ratio was the strongest predictor, and SMI change in four years was a significant negative predictor for glycemic progression. Changes in HOMA β-cell function in four years was a negative predictor for glycemic progression. Increased interval changes in HOMA-IR, weight gain and waist-hip ratio was associated with glycemic progression during a four-year period without intentional intervention in non-diabetic Korean subjects.