The correlation between proinsulin, true insulin, proinsulin: True insulin ratio, 25(OH) D3, waist circumference and risk of prediabetes in Hainan Han adults.

Huibiao Quan,Leweihua Lin,Tuanyu Fang,Kaining Chen,Lu Lin,Qianying Ou,Zhiguang Zhou,Huachuan Zhang,Ying-Mei Feng

doi:10.1371/journal.pone.0238095

Abstract

PurposeDiabetes mellitus is a kind of highly prevalent chronic disease in the world. The intervention measures on the risk factors of prediabetes contribute to control and reduce the occurrence of diabetes. This study aimed to investigate the correlation between proinsulin (PI), true insulin (TI), PI/TI, 25(OH) D3, waist circumference (WC), and risk of prediabetes.MethodsIn this cross-sectional study, 1662 subjects including 615 prediabetes and 1047 non-prediabetes were recruited. Spearman’s correlation analysis was used to explore the association of PI, TI, PI/TI, 25(OH) D3, and waist circumference with prediabetes. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by logistic regression. Receiver-Operator Characteristic (ROC) curve was used to evaluate the risk of prediabetes.ResultsOur study showed that FPI, 2hPI, FTI, 2hTI, FPI/FTI, and WC could enhance the risk of prediabetes (OR 1.034; OR 1.007; OR 1.005; OR 1.002; OR 3.577, OR 1.053, respectively; all p< 0.001). Stratified analyses indicated that FPI/FTI associated with an increased risk of prediabetes in men (OR 2.080, p = 0.042). FTI have a weak association with prediabetes risk in men and women (OR 0.987, p = 0.001; OR 0.994, p = 0.004, respectively). 2hPI could decrease prediabetes in women (OR 0.995, p = 0.037). Interesting, the sensitivity (86.0%) and AUC (0.942, p< 0.001) of combination (FPI+FTI+2hPI+2hTI+25(OH) D3+WC) were higher than the diagnostic value of these alone diagnoses. The optimal cutoff point of FPI, FTI, 2hPI, 2hTI, 25(OH) D3, and WC for indicating prediabetes were 15.5 mU/l, 66.5 mU/l, 71.5 mU/l, 460.5 mU/l, 35.5 ng/ml, and 80.5 cm, respectively. What’s more, the combination (FPI+FTI+2hPI+2hTI+25(OH) D3+WC) significantly improved the diagnostic value beyond the alone diagnoses of prediabetes in men and women (AUC 0.771; AUC 0.760, respectively).ConclusionThe FPI, 2hPI, FTI, 2hTI, FPI/FTI, and WC significantly associated with an increased risk of prediabetes. The combination of FPI, FTI, 2hPI, 2hTI, 25(OH) D3, and WC might be used as diagnostic indicators for prediabetes.

Highlights

Diabetes mellitus (DM) is one of the most important chronic non-infectious diseases in the world, which has a serious impact on people’s lives
Our study showed that FPI, 2hPI, fasting true insulin (FTI), 2hTI, FPI/FTI, and waist circumference (WC) could enhance the risk of prediabetes
Stratified analyses indicated that FPI/FTI associated with an increased risk of prediabetes in men

Summary

Introduction

Diabetes mellitus (DM) is one of the most important chronic non-infectious diseases in the world, which has a serious impact on people’s lives. China holds the largest number of DM patients in the world. According to IDF statistics in 2013, the number of patients with DM aged 20–79 years in China is about 98 million, which is expected to grow to 143 million by 2035 [1]. The epidemiological survey in 2010 showed that the number of patients with diabetes and prediabetes in China increased to 114 million and 493 million respectively, being accountable for 11.6% and 50.1% of adults [2]. People with prediabetes risk factors are most likely to develop diabetes than the general population [3]. The intervention measures on the risk factors of prediabetes should be strengthened to control and reduce the occurrence of diabetes as far as possible

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