Pretransplant Homeostasis Model Assessment of Insulin Resistance and Fasting Plasma Glucose Predict New-Onset Diabetes After Renal Transplant in Chinese Patients

2019 ◽  
Vol 51 (3) ◽  
pp. 768-773 ◽  
Author(s):  
R. Cai ◽  
M. Wu ◽  
M. Lin ◽  
X. Guo ◽  
Y. Xing
Diabetologia ◽  
1985 ◽  
Vol 28 (7) ◽  
pp. 412-419 ◽  
Author(s):  
D. R. Matthews ◽  
J. P. Hosker ◽  
A. S. Rudenski ◽  
B. A. Naylor ◽  
D. F. Treacher ◽  
...  

Twin Research ◽  
2000 ◽  
Vol 3 (3) ◽  
pp. 148-151 ◽  
Author(s):  
Arthur B Jenkins ◽  
Katherine Samaras ◽  
David GP Carey ◽  
Paul Kelly ◽  
Lesley V Campbell

AbstractHomeostasis model assessment (HOMA) provides indices of insulin secretion (β) and insulin resistance (R) derived from fasting plasma glucose (FPG) and fasting plasma insulin (FPI) levels. However, these indices could not account for a significant heritability of fasting plasma glucose (FPG) (h2 = 0.75, P < 0.01) in a group of 214 female twins. This result is consistent with a misclassification between effects due to insulin secretion and resistance in the HOMA indices. We report here evidence of such misclassification in the HOMA indices and describe a minor modification to the model which corrects it. Direct measures of insulin resistance (euglycaemic clamp) and secretion (i.v. glucose bolus) were obtained in 43 non-diabetic subjects. Heritability was estimated by statistical modelling of genetic and environmental influences in data from 214 non-diabetic female subjects. Modified HOMA (HOMA′) indices were obtained from β′ = (Ln(FPI)–c)/FPG and R′ = (Ln(FPI)–c)* FPG where c is a constant derived from regression analysis of Ln(FPI) vs FPG. Indices from both models correlated with the direct measures similarly (r = 0.63 (R), 0.49 (R′), 0.45 (β), 0.39 (β′), all P < 0.01). Directly measured insulin resistance and secretion were not significantly correlated (r = 0.13, P = 0.21). However, unmodified HOMA- and R were strongly related (r = 0.78, P < 0.0001 vs 0.13) demonstrating substantial misclassification. The relationship between β′ and R′ (r = 0.13) was not different from that between the two direct measures and significant heritability of β′ (h2 = 0.68, P < 0.01) and R′ (h2 = 0.59, P < 0.05) was evident in the twin data. The proposed modification to HOMA significantly reduces misclassification and reveals separate components of insulin resistance and insulin secretion in the heritability of FPG. Twin Research (2000) 3, 148–151.


Author(s):  
Kuo‐Tzu Sung ◽  
Jen‐Yuan Kuo ◽  
Chun‐Ho Yun ◽  
Yueh‐Hung Lin ◽  
Jui‐Peng Tsai ◽  
...  

Background Visceral adipose tissue is assumed to be an important indicator for insulin resistance and diabetes beyond overweight/obesity. We hypothesized that region‐specific visceral adipose tissue may regulate differential biological effects for new‐onset diabetes regardless of overall obesity. Methods and Results We quantified various visceral adipose tissue measures, including epicardial adipose tissue, paracardial adipose tissue, interatrial fat, periaortic fat, and thoracic aortic adipose tissue in 1039 consecutive asymptomatic participants who underwent multidetector computed tomography. We explored the associations of visceral adipose tissue with baseline dysglycemic indices and new‐onset diabetes. Epicardial adipose tissue, paracardial adipose tissue, interatrial fat, periaortic fat, and thoracic aortic adipose tissue were differentially and independently associated with dysglycemic indices (fasting glucose, postprandial glucose, HbA1c, and homeostasis model assessment of insulin resistance) beyond anthropometric measures. The superimposition of interatrial fat and thoracic aortic adipose tissue on age, sex, body mass index, and baseline homeostasis model assessment of insulin resistance expanded the likelihood of baseline diabetes (from 67.2 to 86.0 and 64.4 to 70.8, P for ∆ ꭕ 2 : <0.001 and 0.011, respectively). Compared with the first tertile, the highest interatrial fat tertile showed a nearly doubled risk for new‐onset diabetes (hazard ratio, 2.09 [95% CI, 1.38–3.15], P <0.001) after adjusting for Chinese Visceral Adiposity Index. Conclusions Region‐specific visceral adiposity may not perform equally in discriminating baseline dysglycemia or diabetes, and showed differential predictive performance in new‐onset diabetes. Our data suggested that interatrial fat may serve as a potential marker for new‐onset diabetes.


2008 ◽  
Vol 78 (2) ◽  
pp. 57-63 ◽  
Author(s):  
Komindr ◽  
Viroonudomphol ◽  
Cherdchu

For a group of 73 males and 247 females, being health-conscious and from the lower middle class of Bangkok, with various degrees of the nutritional status defined by the new criteria for Asians, the relationship of anthropometric indicators and the plasma lipid status to fasting glucose, fasting plasma insulin, and the homeostasis model assessment for insulin-resistance (HOMA-IR) has been studied. For assessing differences among groups either the Mann-Whitney U-test or the Kruskal-Wallis analysis of variance for multiple comparisons were applied. Multivariate regression models were computed to assess variation of glucose, insulin, and the HOMA-IR due to the nutritional status and serum lipids. A significant increase in fasting plasma glucose for both sexes and for females for the HOMA-IR models could be observed for the group with a body-mass index (BMI) range of 23 to less than 25. Insulin concentrations and HOMA-IR correlated for both sexes, especially with BMI and hip circumference, while the variation of fasting plasma glucose is less dependent on anthropometric nutritional indicators in comparison to insulin and HOMA-IR. Only the lipid status of females weakly correlated with insulin and HOMA-IR.


2020 ◽  
Vol 105 (10) ◽  
pp. e3519-e3528 ◽  
Author(s):  
Xia Li ◽  
Shuting Yang ◽  
Chuqing Cao ◽  
Xiang Yan ◽  
Lei Zheng ◽  
...  

Abstract Context This study applied the Swedish novel data-driven classification in Chinese newly diagnosed diabetic patients and validated its adoptability. Objective This study aimed to validate the practicality of the Swedish diabetes regrouping scheme in Chinese adults with newly diagnosed diabetes. Design Patients were classified into 5 subgroups by K-means and Two-Step methods according to 6 clinical parameters. Setting Ambulatory care. Patients A cross-sectional survey of 15 772 patients with adult-onset newly diagnosed diabetes was conducted in China from April 2015 to October 2017. Intervention None. Main Outcome Measures Six parameters including glutamate decarboxylase antibodies (GADA), age of onset, body mass index (BMI), glycated hemoglobin A1c (HbA1c), homoeostatic model assessment 2 estimates of β-cell function (HOMA2-B) and insulin resistance (HOMA2-IR) were measured to calculate the patient subgroups. Results Our patients clustered into 5 subgroups: 6.2% were in the severe autoimmune diabetes (SAID) subgroup, 24.8% were in the severe insulin-deficient diabetes (SIDD) subgroup, 16.6% were in the severe insulin-resistance diabetes (SIRD) subgroup, 21.6% were in the mild obesity-related diabetes (MOD) subgroup and 30.9% were in the mild age-related diabetes (MARD) subgroup. When compared with the Swedish population, the proportion of SIDD subgroup was higher. In general, Chinese patients had younger age, lower BMI, higher HbA1c, lower HOMA2-B and HOMA2-IR, and higher insulin use but lower metformin usage than the Swedish patients. Conclusion The Swedish diabetes regrouping scheme is applicable to adult-onset diabetes in China, with a high proportion of patients with the severe insulin deficient diabetes. Further validations of long-term diabetes complications remain warranted in future studies.


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