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Effect of Body Mass Index on Insulin Secretion or Sensitivity and Diabetes

Published:November 09, 2014DOI:https://doi.org/10.1016/j.amepre.2014.09.009

      Background

      Although the association between obesity and diabetes is well known, the factors predisposing to diabetes in non-obese Asians are less clearly characterized.

      Purpose

      To investigate the effects of impaired insulin secretion (IIS) and insulin resistance (IR) according to BMI on the incidence of diabetes in the Saku Study.

      Methods

      This 4-year cohort study involved 3,083 participants aged 30–69 years without diabetes at baseline (2006–2007). Participants were stratified by BMI (<23.0, 23.0–24.9, and ≥25). Based on insulinogenic index and homeostasis model of IR values, participants were classified into four categories: normal; isolated IIS (i-IIS); isolated IR (i-IR); and IIS plus IR. All data were collected in 2006–2011 and analyzed in 2013–2014.

      Results

      For participants with BMI <23.0, the risk of developing diabetes was higher in the i-IIS (adjusted hazard ratio=6.6; 95% CI=3.7, 11.6) and IIS plus IR groups (9.4; 3.1, 28.4) than in the normal group. For participants with BMI 23.0–24.9, risk was higher in the i-IIS (9.9; 4.4, 22.1); i-IR (3.4; 1.2, 9.5); and IIS plus IR (23.4; 9.3, 58.9) groups. Among participants with BMI ≥25, risk was higher in the i-IIS (16.9; 6.0, 47.7); i-IR (7.9; 2.8, 22.6); and IIS plus IR (26.9; 9.0, 80.8) groups. BMI was negatively associated with incidence of IIS but positively associated with IR incidence.

      Conclusions

      Individuals with normal BMI may develop diabetes mainly through IIS, whereas individuals with high BMI may develop diabetes primarily through IR.
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      References

        • Abdullah A.
        • Peeters A.
        • de Courten M.
        • Stoelwinder J.
        The magnitude of association between overweight and obesity and the risk of diabetes: a meta-analysis of prospective cohort studies.
        Diabetes Res Clin Pract. 2010; 89: 309-319
        • Duval S.
        • Vazquez G.
        • Baker W.L.
        • Jacobs Jr, D.R.
        • CODA Study Group
        The Collaborative Study of Obesity and Diabetes in Adults (CODA) project: meta-analysis design and description of participating studies.
        Obes Rev. 2007; 8: 263-276
        • Kodama K.
        • Tojjar D.
        • Yamada S.
        • Toda K.
        • Patel C.J.
        • Butte A.J.
        Ethnic differences in the relationship between insulin sensitivity and insulin response: a systematic review and meta-analysis.
        Diabetes Care. 2013; 36: 1789-1796
        • Lee J.W.
        • Brancati F.L.
        • Yeh H.C.
        Trends in the prevalence of type 2 diabetes in Asians versus whites: results from the United States National Health Interview Survey, 1997-2008.
        Diabetes Care. 2011; 34: 353-357
        • Sairenchi T.
        • Iso H.
        • Irie F.
        • Fukasawa N.
        • Ota H.
        • Muto T.
        Underweight as a predictor of diabetes in older adults: a large cohort study.
        Diabetes Care. 2008; 31: 583-584
        • Tatsumi Y.
        • Ohno Y.
        • Morimoto A.
        • et al.
        U-shaped relationship between body mass index and incidence of diabetes.
        Diabetol Int. 2012; 3: 92-98
        • Fukushima M.
        • Usami M.
        • Ikeda M.
        • et al.
        Insulin secretion and insulin sensitivity at different stages of glucose tolerance: a cross-sectional study of Japanese type 2 diabetes.
        Metabolism. 2004; 53: 831-835
        • Tripathy D.
        • Carlsson M.
        • Almgren P.
        • et al.
        Insulin secretion and insulin sensitivity in relation to glucose tolerance: lessons from the Botnia Study.
        Diabetes. 2000; 49: 975-980
        • Tayek J.A.
        • Manglik S.
        • Abemayor E.
        Insulin secretion, glucose production, and insulin sensitivity in underweight and normal-weight volunteers, and in underweight and normal-weight cancer patients: a Clinical Research Center study.
        Metabolism. 1997; 46: 140-145
        • Morimoto A.
        • Tatsumi Y.
        • Deura K.
        • et al.
        Impact of impaired insulin secretion and insulin resistance on the incidence of type 2 diabetes mellitus in a Japanese population: the Saku study.
        Diabetologia. 2013; 56: 1671-1679
        • Matthews D.R.
        • Hosker J.P.
        • Rudenski A.S.
        • Naylor B.A.
        • Treacher D.F.
        • Turner R.C.
        Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man.
        Diabetologia. 1985; 28: 412-419
        • Seltzer H.S.
        • Allen E.W.
        • Herron Jr, A.L.
        • Brennan M.T.
        Insulin secretion in response to glycemic stimulus: Relation of delayed initial release to carbohydrate intolerance in mild diabetes mellitus.
        J Clin Invest. 1967; 46: 323-335
        • Kosaka K.
        • Kuzuya T.
        • Yoshinaga H.
        • Hagura R.
        A prospective study of health check examinees for the development of non-insulin-dependent diabetes mellitus: relationship of the incidence of diabetes with the initial insulinogenic index and degree of obesity.
        Diabet Med. 1996; 13: S120-S126
        • Nakai Y.
        • Nakaishi S.
        • Kishimoto H.
        • et al.
        The threshold value for insulin resistance on homeostasis model assessment of insulin sensitivity.
        Diabet Med. 2002; 19: 346-347
      1. The Japan Diabetes Society. Evidence-based practice guideline for the treatment of diabetes in Japan, 2010. Tokyo: Nankodo, 2010. [guideline in Japanese]

      2. The Japan Diabetes Society. Treatment guide for diabetes, 2010. Tokyo: Bunkodo, 2010. [guide in Japanese]

        • World Health Organization
        Report of a WHO Consultation: Definition, diagnosis and classification of diabetes mellitus and its complications: Part 1. Diagnosis and classification of diabetes mellitus.
        WHO, Department of Noncommunicable Disease Surveillance, Geneva, Switzerland1999
        • WHO
        Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies.
        Lancet. 2004; 363: 157-163
        • Mneilly G.S.
        • Elliott T.
        • Tessier D.
        • Hards L.
        • Tildesley H.
        NIDDM in the elderly.
        Diabetes Care. 1996; 19: 1320-1325
        • Robertson R.P.
        • Harmon J.
        • Tran P.O.
        • Tanaka Y.
        • Takahashi H.
        Glucose toxicity in beta-cells: type 2 diabetes, good radicals gone bad, and the glutathione connection.
        Diabetes. 2003; 52: 581-587
        • Cerasi E.
        • Luft R.
        • Efendic S.
        Decreased sensitivity of the pancreatic beta cells to glucose in prediabetic and diabetic subjects. A glucose dose-response study.
        Diabetes. 1972; 21: 224-234
        • Sato Y.
        • Komatsu M.
        • Katakura M.
        • et al.
        Diminution of early insulin response to glucose in subjects with normal but minimally elevated fasting plasma glucose. Evidence for early beta-cell dysfunction.
        Diabet Med. 2002; 19: 566-571
        • Hu C.
        • Wang C.
        • Zhang R.
        • et al.
        Variations in KCNQ1 are associated with type 2 diabetes and beta cell function in a Chinese population.
        Diabetologia. 2009; 52: 1322-1325
        • Jonsson A.
        • Isomaa B.
        • Tuomi T.
        • et al.
        A variant in the KCNQ1 gene predicts future type 2 diabetes and mediates impaired insulin secretion.
        Diabetes. 2009; 58: 2409-2413
        • van Vliet-Ostaptchouk J.V.
        • van Haeften T.W.
        • Landman G.W.
        • et al.
        Common variants in the type 2 diabetes KCNQ1 gene are associated with impairments in insulin secretion during hyperglycaemic glucose clamp.
        PLoS One. 2012; 7: e32148
        • Okamoto K.
        • Iwasaki N.
        • Nishimura C.
        • et al.
        Identification of KCNJ15 as a susceptibility gene in Asian patients with type 2 diabetes mellitus.
        Am J Hum Genet. 2010; 86: 54-64
        • Okamoto K.
        • Iwasaki N.
        • Doi K.
        • et al.
        Inhibition of glucose-stimulated insulin secretion by KCNJ15, a newly identified susceptibility gene for type 2 diabetes.
        Diabetes. 2012; 61: 1734-1741
        • Edderkaoui M.
        • Thrower E.
        Smoking and pancreatic disease.
        J Cancer Ther. 2013; 4: 34-40
        • Morimoto A.
        • Tatsumi Y.
        • Deura K.
        • Mizuno S.
        • Ohno Y.
        • Watanabe S.
        Impact of cigarette smoking on impaired insulin secretion and insulin resistance in Japanese men: the Saku Study.
        J Diabetes Investig. 2013; 4: 274-280
        • Kadowaki T.
        • Yamauchi T.
        • Kubota N.
        • Hara K.
        • Ueki K.
        • Tobe K.
        Adiponectin and adiponectin receptors in insulin resistance, diabetes, and the metabolic syndrome.
        J Clin Invest. 2006; 116: 1784-1792
        • Yoshiike N.
        • Seino F.
        • Tajima S.
        • et al.
        Twenty-year changes in the prevalence of overweight in Japanese adults: the National Nutrition Survey 1976-95.
        Obesity. 2002; 3: 183-190
        • Yoshiike N.
        • Kaneda F.
        • Takimoto H.
        Epidemiology of obesity and public health strategies for its control in Japan.
        Asia Pac J Clin Nutr. 2002; 11: S727-S731
        • Tripathy D.
        • Almgren P.
        • Tuomi T.
        • Groop L.
        Contribution of insulin-stimulated glucose uptake and basal hepatic insulin sensitivity to surrogate measures of insulin sensitivity.
        Diabetes Care. 2004; 27: 2204-2210
        • MacMahon S.
        • Peto R.
        • Cutler J.
        • et al.
        Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias..
        Lancet. 1990; 335: 765-774
      3. Japanese Ministry of Health, Labour and Welfare. National Health and Nutrition Survey [in Japanese]. Tokyo, Japan: Japanese Ministry of Health, Labour and Welfare; 2005. http://www.mhlw.go.jp/bunya/kenkou/eiyou07/dl/01-03.pdf.