Abstract
BackgroundSeveral studies have reported that insulin resistance was a major risk factor for the onset of type 2 diabetes mellitus in individuals without diabetes or obesity. We aimed to clarify the association between insulin resistance and glycemic control in Japanese subjects without diabetes or obesity.MethodsWe conducted a community-based cross-sectional study including 1083 healthy subjects (323 men and 760 women) in an urban area. We performed multivariate regression analyses to estimate the association between the homeostasis model assessment of insulin resistance (HOMA-IR) values and markers of glycemic control, including glycated haemoglobin (HbA1c), 1,5-anhydroglucitol (1,5-AG), and fasting plasma glucose (FPG) levels, after adjustment for potential confounders.ResultsCompared with the lowest tertile of HOMA-IR values, the highest tertile was significantly associated with HbA1c and FPG levels after adjustment for potential confounders, both in men (HbA1c: β = 1.83, P = 0.001; FPG: β = 0.49, P < 0.001) and women (HbA1c: β = 0.82, P = 0.008; FPG: β = 0.39, P < 0.001). The highest tertile of HOMA-IR values was inversely associated with 1,5-AG levels compared with the lowest tertile (β = −18.42, P = 0.009) only in men.ConclusionsHOMA-IR values were associated with markers of glycemic control in Japanese subjects without diabetes or obesity. Insulin resistance may influence glycemic control even in a lean, non-diabetic Asian population.
Highlights
HbA1c and fasting plasma glucose (FPG) levels were significantly higher in the highest tertile group of homeostasis model assessment of insulin resistance (HOMA-IR) values than in the lowest tertile group, both in men and women. 1,5-AG levels were significantly lower in the highest tertile group of HOMA-IR values than in the lowest tertile group in men but not in women
The results showed that the absolute values of coefficient were larger in the group with high body mass index (BMI) than in the group with low BMI in men, which suggested a strong association between HOMA-IR and these glycemic control parameters; these findings were not clearly observed in women
We found that HOMA-IR values were significantly associated with all indices of glucose metabolism in men, as well as with HbA1c or FPG levels in women
Summary
Insulin resistance is a clinical condition characterized by a decreased sensitivity to insulin in peripheral tissues and is strongly associated with metabolic diseases, such as type 2 diabetes mellitus and obesity.[1,2,3] Prospective cohort studies in subjects without diabetes have revealed that increased insulin resistance worsened glycemic control and contributed to the development of type 2 diabetes mellitus.[4,5,6] in all previous reports, the average body mass index (BMI) of the subjects was high (28–33 kg/m2), and >50% of the subjects were obese.[4,5,6] it is unclear whether insulin resistance affects glycemic control in subjects without obesity or diabetes.For assessing glycemic control, temporal variations in the indicative parameters are more important than values obtained at a single point in time. Glycated hemoglobin (HbA1c) and 1,5-anhydroglucitol (1,5-AG) levels are generally used to HOMA-IR and Glycemic Control in Non-Diabetic Non-Obese Japanese Subjects evaluate glycemic control in clinical practice. We performed multivariate regression analyses to estimate the association between the homeostasis model assessment of insulin resistance (HOMA-IR) values and markers of glycemic control, including glycated haemoglobin (HbA1c), 1,5-anhydroglucitol (1,5-AG), and fasting plasma glucose (FPG) levels, after adjustment for potential confounders. Results: Compared with the lowest tertile of HOMA-IR values, the highest tertile was significantly associated with HbA1c and FPG levels after adjustment for potential confounders, both in men (HbA1c: β = 1.83, P = 0.001; FPG: β = 0.49, P < 0.001) and women (HbA1c: β = 0.82, P = 0.008; FPG: β = 0.39, P < 0.001). Insulin resistance may influence glycemic control even in a lean, non-diabetic Asian population
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