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β-cell dysfunction and insulin resistance in relation to pre-diabetes and diabetes among adults in north-western Tanzania: a cross-sectional study.
- Source :
- Tropical Medicine & International Health; Apr2021, Vol. 26 Issue 4, p435-443, 9p
- Publication Year :
- 2021
-
Abstract
- <bold>Objective: </bold>Studies on phenotypes of diabetes in Africa are inconsistent. We assessed the role of β-cell dysfunction and insulin resistance on pre-diabetes and diabetes.<bold>Methods: </bold>We included 1890 participants with mean age of 40.6 (SD11.9) years in a cross-sectional study among male and female adults in Tanzania during 2016 to 2017. Data on C-reactive protein (CRP), alpha-acid glycoprotein (AGP), HIV, oral glucose tolerance test (OGTT), body composition and insulin were collected. Insulinogenic index and HOMA-IR were used to derive an overall marker of β-cell dysfunction and insulin resistance which was categorised as follows: normal β-cell function and insulin sensitivity, isolated β-cell dysfunction, isolated insulin resistance, and combined β-cell dysfunction and insulin resistance. Pre-diabetes and diabetes were defined as 2-hour OGTT glucose between 7.8-11.0 and ≥ 11.1 mmol/L, respectively. Multinomial regression assessed the association of β-cell dysfunction and insulin resistance with outcome measures.<bold>Results: </bold>β-cell dysfunction, insulin resistance, and combined β-cell dysfunction and insulin resistance were associated with higher pre-diabetes risk. Similarly, isolated β-cell dysfunction (adjusted relative risk ratio (aRRR) 4.8 (95% confidence interval (CI) 2.5, 9.0), isolated insulin resistance (aRRR 3.2 (95% CI 1.5, 6.9), and combined β-cell dysfunction and insulin resistance (aRRR 35.9 (95% CI 17.2, 75.2) were associated with higher diabetes risk. CRP, AGP and HIV were associated with higher diabetes risk, but fat mass was not. 31%, 10% and 33% of diabetes cases were attributed to β-cell dysfunction, insulin resistance, and combined β-cell dysfunction and insulin resistance, respectively.<bold>Conclusions: </bold>β-cell dysfunction seemed to explain most of diabetes cases compared to insulin resistance in this population. Cohort studies on evolution of diabetes in Africa are needed to confirm these results. [ABSTRACT FROM AUTHOR]
- Subjects :
- INSULIN resistance
PREDIABETIC state
INSULIN sensitivity
DIABETES
GLUCOSE tolerance tests
BODY composition
HIV infections
C-reactive protein
RESEARCH
CROSS-sectional method
RESEARCH methodology
BLOOD sugar
MEDICAL cooperation
EVALUATION research
INSULIN
TYPE 2 diabetes
ISLANDS of Langerhans
COMPARATIVE studies
GLYCOPROTEINS
Subjects
Details
- Language :
- English
- ISSN :
- 13602276
- Volume :
- 26
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Tropical Medicine & International Health
- Publication Type :
- Academic Journal
- Accession number :
- 149597971
- Full Text :
- https://doi.org/10.1111/tmi.13545