Back to Search
Start Over
Earlier appearance of impaired insulin secretion than of visceral adiposity in the pathogenesis of NIDDM. 5-Year follow-up of initially nondiabetic Japanese-American men.
- Source :
-
Diabetes care [Diabetes Care] 1995 Jun; Vol. 18 (6), pp. 747-53. - Publication Year :
- 1995
-
Abstract
- OBJECTIVE--To identify risk factors for development of non-insulin-dependent diabetes mellitus (NIDDM) during a 5-year longitudinal follow-up of second-generation Japanese-American (Nisei) men. RESEARCH DESIGN AND METHODS--For 5 years, 137 initially nondiabetic Nisei men were followed with 75-g oral glucose tolerance tests at the initial visit and at 2.5- and 5-year follow-up visits. Body fat distribution was assessed by computed tomography (CT) and body mass index (BMI) calculated at each visit. Fasting insulin and C-peptide, the increment of insulin and C-peptide at 30 min after the oral glucose load, intra-abdominal and total subcutaneous fat by CT, and BMI were compared between those who remained nondiabetic (non-DM) and those who had developed NIDDM at 2.5 years (DM-A) and 5 years (DM-B). RESULTS--At baseline, the DM-A group had significantly increased intra-abdominal fat, elevated fasting plasma C-peptide, and lower C-peptide response at 30 min after oral glucose. At the 2.5-year follow-up, this group had markedly increased fasting plasma insulin and decreased 30-min insulin and C-peptide response to oral glucose. The DM-B group also had significantly lower insulin response at 30 min after oral glucose at baseline but no significant difference in intra-abdominal fat or fasting plasma insulin and C-peptide levels. When this group developed NIDDM by 5-year follow-up, however, an increase of intra-abdominal fat was found superimposed on the pre-existing lower insulin response. Fasting plasma insulin and C-peptide remained low. CONCLUSION--In DM-A, lower 30-min insulin response to oral glucose (an indicator of beta-cell lesion) and increased intra-abdominal fat and fasting C-peptide (indicators of insulin resistance) were the risk factors related to the development of NIDDM. DM-B subjects had a lower 30-min insulin response to oral glucose at baseline and increased intra-abdominal fat at 5-years, when they were found to have NIDDM. Thus, both insulin resistance and impaired beta-cell function contribute to the development of NIDDM in Japanese-Americans, and impaired beta-cell function may be present earlier than visceral adiposity in some who subsequently develop NIDDM.
- Subjects :
- Analysis of Variance
Blood Glucose metabolism
Body Mass Index
C-Peptide blood
Diabetes Mellitus, Type 2 blood
Diabetes Mellitus, Type 2 physiopathology
Fasting
Glucose Tolerance Test
Humans
Insulin blood
Insulin Secretion
Islets of Langerhans metabolism
Islets of Langerhans physiopathology
Japan ethnology
Longitudinal Studies
Male
Middle Aged
Risk Factors
Time Factors
United States epidemiology
Viscera
Adipose Tissue anatomy & histology
Diabetes Mellitus, Type 2 epidemiology
Insulin metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 0149-5992
- Volume :
- 18
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Diabetes care
- Publication Type :
- Academic Journal
- Accession number :
- 7555498
- Full Text :
- https://doi.org/10.2337/diacare.18.6.747