The evolution of non-diabetic hyperglycemia: a longitudinal study

The risk factors for impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) have yet to be established. Our aim was to elucidate the predisposing factors for IFG and IGT in Japanese subjects with normal glucose tolerance (NGT). Using a 75 g oral glucose tolerance test (OGTT), we analyze...

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Published in:ENDOCRINE JOURNAL 2014, Vol.61(1), pp.91-99
Main Authors: Oka, Rie, Yagi, Kunimasa, Hayashi, Kenshi, Kawashiri, Masa-aki, Yamagishi, Masakazu, Yamada, Masayuki, Fumisawa, Yasushi, Yamauchi, Keishi, Aizawa, Toru
Format: Article
Language:English
Subjects:
Blood Glucose - analysis
Body Mass Index
Diabetes Mellitus - prevention & control
Fasting
Female
Glucose Intolerance - etiology
Glucose Tolerance Test
Humans
Hyperglycemia - etiology
Hyperglycemia - physiopathology
Impaired fasting glucose
Impaired glucose tolerance
Insulin - metabolism
Insulin Resistance
Insulin Secretion
Insulin-Secreting Cells - physiology
Japan
Logistic Models
Longitudinal Studies
Male
Middle Aged
Normal glucose tolerance
OGTT
Prediabetic State
Retrospective Studies
Risk Factors
Sex Factors
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Summary:The risk factors for impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) have yet to be established. Our aim was to elucidate the predisposing factors for IFG and IGT in Japanese subjects with normal glucose tolerance (NGT). Using a 75 g oral glucose tolerance test (OGTT), we analyzed 604 adults with the ADA-defined NGT. Follow-up glucose tolerance status was determined by 75 g OGTT performed 3.7 yrs later. Glucose-stimulated insulin secretion (GSIS), whole body insulin sensitivity (SI) and beta cell function (BCF) were estimated by Stumvoll indices, ISIMatsuda, and a product of Stumvoll 1st and ISIMatsuda, respectively, and hepatic SI by quantitative insulin sensitivity check index. Logistic regression analysis revealed that attenuated BCF due to low GSIS was an independent risk factor for IFG. Low whole body SI was an additional risk for IGT. Male gender and high BMI were independently related to the progression to both IFG and IGT, whereas a positive diabetes family history was independently related to IGT. The worsening of glucose tolerance at large was predicted with 66% sensitivity by risk engine with GSIS, whole body SI, gender, BMI and glucose. This finding may help when implementing early intervention strategies for diabetes.
ISSN:0918-8959
1348-4540
DOI:10.1507/endocrj.EJ13-0359