TY - JOUR
T1 - The roles of first phase, second phase insulin secretion, insulin resistance, and glucose effectiveness of having prediabetes in nonobese old Chinese women
AU - Lu, Chieh Hua
AU - Teng, Sen Wen
AU - Wu, Chung Ze
AU - Hsieh, Chang Hsun
AU - Chang, Jin Biou
AU - Chen, Yen Lin
AU - Liang, Yao Jen
AU - Hsieh, Po Shiuan
AU - Pei, Dee
AU - Lin, Jiunn Diann
N1 - Funding Information:
This study was funded by the grant from the Cardinal Tien Hospital No. CTH-104-1-2A13, and the Tri-Service General Hospital No. TSGH-C108-142. The authors have no conflicts of interest to disclose. aDepartment of Internal Medicine, Division of Endocrinology and Metabolism, Tri-Service General Hospital, National Defense Medical Center, bDepartment of Medical Research, NDMC, Taipei, cDepartment of Obstetrics and Gynecology, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, dDivision of Endocrinology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University; Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, eDivision of Endocrinology and Metabolism, Department of Internal Medicine, fDepartment of Pathology, National Defense Medical Center, Division of Clinical Pathology, Tri-Service General Hospital, R.O.C, gDepartment of Pathology, Cardinal Tien Hospital, School of Medicine, hAssociate Dean of College of Science and Engineering, Director of Graduate Institute of Applied Science and Engineering, Department and Institute of Life-Science, Fu-Jen Catholic University, New Taipei City, iDepartment of Physiology and Biophysics, jInstitute of Preventive Medicine, National Defense Medical Center, Taipei, kDepartment of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan. ∗Correspondence: Jiunn-Diann Lin, Division of Endocrinology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, No. 291, Jhongzheng Rd., Jhonghe District, New Taipei City 23561, Taiwan (e-mail: jdlin1971@yahoo.com.tw), Dee Pei, Department of Internal Medicine, Cardinal Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan (e-mail: peidee@gmail.com).
Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020
Y1 - 2020
N2 - AbstractIt has been established that prediabetes can causes significant comorbidities, particularly in the elderly. The deterioration of glucose metabolism are generally considered to be results of the impairment of the 4 factors: first, second insulin secretion (FPIS, SPIS, respectively), glucose effectiveness (GE), and insulin resistance. In this study, we enrolled older women to investigate their relationships with prediabetes.Five thousand four hundred eighty-two nonobese, nondiabetic women were included. They were divided into normal glucose tolerance and prediabetes groups. Receiver operating characteristic curve was performed to investigate the effects on whether to have prediabetes for each factors. Two models were built: Model 1: FPIS + SPIS, and Model 2: model 1 + GE. The area under the receiver operating characteristic (aROC) curve was used to determine the predictive power of these models.The aROC curve of GE was significantly higher than the diagonal line followed by SPIS and FPIS accordingly. The aROC curve of Model 1 (0.611) was not different from GE. However, Model 2 improved significantly up to 0.663. Based on this model, an equation was built (-0.003 × GE - 212.6 × SPIS - 17.9 × insulin resistance + 4.8). If the calculated value is equal or higher than 0 (≥0), then the subject has higher chance to have prediabetes (sensitivity = 0.607, specificity = 0.635).Among the 4 factors, GE is the most important contributor for prediabetes in older women. By building a model composed of FPIS, SPIS, and GE, the aROC curve increased significantly. The equation built from this model could predict prediabetes precisely.
AB - AbstractIt has been established that prediabetes can causes significant comorbidities, particularly in the elderly. The deterioration of glucose metabolism are generally considered to be results of the impairment of the 4 factors: first, second insulin secretion (FPIS, SPIS, respectively), glucose effectiveness (GE), and insulin resistance. In this study, we enrolled older women to investigate their relationships with prediabetes.Five thousand four hundred eighty-two nonobese, nondiabetic women were included. They were divided into normal glucose tolerance and prediabetes groups. Receiver operating characteristic curve was performed to investigate the effects on whether to have prediabetes for each factors. Two models were built: Model 1: FPIS + SPIS, and Model 2: model 1 + GE. The area under the receiver operating characteristic (aROC) curve was used to determine the predictive power of these models.The aROC curve of GE was significantly higher than the diagonal line followed by SPIS and FPIS accordingly. The aROC curve of Model 1 (0.611) was not different from GE. However, Model 2 improved significantly up to 0.663. Based on this model, an equation was built (-0.003 × GE - 212.6 × SPIS - 17.9 × insulin resistance + 4.8). If the calculated value is equal or higher than 0 (≥0), then the subject has higher chance to have prediabetes (sensitivity = 0.607, specificity = 0.635).Among the 4 factors, GE is the most important contributor for prediabetes in older women. By building a model composed of FPIS, SPIS, and GE, the aROC curve increased significantly. The equation built from this model could predict prediabetes precisely.
KW - first phase insulin secretion
KW - glucose effectiveness
KW - insulin resistance
KW - prediabetes
KW - second phase insulin secretion
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U2 - 10.1097/MD.0000000000019562
DO - 10.1097/MD.0000000000019562
M3 - Article
C2 - 32195965
AN - SCOPUS:85082147342
SN - 0025-7974
VL - 99
JO - Medicine (United States)
JF - Medicine (United States)
IS - 12
M1 - e19562
ER -