Abstract P043: Twelve-Year Trajectories of Insulin Sensitivity from Oral Glucose Tolerance Tests Are Associated With Incident Dyslipidemia: The Ansan-Ansung Community Cohort Study

Abstract

Introduction: Insulin resistance and dyslipidemia are often comorbid. Although possible biochemical explanations exist, there are inadequate longitudinal data to support the theory directly. Objectives: This study aimed to test the association between twelve-year trajectories of insulin sensitivity from oral glucose tolerance test (OGTT) and the incidence of dyslipidemia in a community cohort. Secondly, we tested which lipidemia profile is associated with trajectories. Methods: Participants (n=3899; aged 40-69 years, during 1 to 7 visit, mean follow-up 12 years) were recruited from the Ansan-Ansung cohort study, a subset of Korean Genome Epidemiology Study. OGTT were measured at every visit. Matsuda index of each visit was calculated by the formula 10 4 /((GLU0xINS0xGLU60xINS60) 0.5 ). We used total seven times of OGTT (28 OGTT index) for trajectories. Latent mixture modeling was used to identify trajectories in Matsuda index for 12 years. The associations of Matsuda index trajectories with the incidence of dyslipidemia and each component of the lipid profile during 12 years were assessed by logistic regression. Age, body mass index, alcohol drinking, cigarette smoking, c reactive protein, education level, and income were adjusted at the final model. Results: Three distinct insulin sensitivity trajectories were identified: low-stable (Group 1; 88.8%), steady decreasing (Group 2; 9.7%), and fast decreasing (Group 3; 1.5%). Low stable cluster (referent: steady decreasing) was associated with greater incident dyslipidemia in total (OR=1.61, 1.25-2.07), and men (OR=2.03, 1.45-2.86) before and after adjustment (OR=2.03, 1.32-3.12, OR=2.08, 1.35-3.22). The low stable cluster was associated with the greater incidence of triglycerides≥200mg/dl in total (OR=1.61, 1.18-2.19), and men (OR=1.59, 1.06-2.40). Also, the low stable cluster was associated with greater incident HDL<40mg/dl in total (OR=1.35, 1.06-1.71), and men (OR=1.81, 1.30-2.53). However low stable cluster was not associated with LDL and total cholesterol. Conclusions: Longterm low stable insulin sensitivity trajectory had increased associations with future incident dyslipidemia especially TG and HDL component.