Proinsulin to insulin ratio is associated with incident type 2 diabetes but not with vascular complications in the KORA F4/FF4 study

IntroductionWe investigated the association of the proinsulin to insulin ratio (PIR) with prevalent and incident type 2 diabetes (T2D), components of the metabolic syndrome, and renal and cardiovascular outcomes in the population-based Cooperative Health Research in the Region of Augsburg (KORA) F4 study (2006–2008)/FF4 study (2013–2014).Research design and methodsThe analyses included 1514 participants of the KORA F4 study at baseline and 1132 participants of the KORA FF4 study after a median follow-up time of 6.6 years. All-cause and cardiovascular mortality as well as cardiovascular events were analyzed after a median time of 9.1 and 8.6 years, respectively. The association of PIR with T2D, renal and cardiovascular characteristics and mortality were assessed using logistic regression models. Linear regression analyses were used to assess the association of PIR with components of the metabolic syndrome.ResultsAfter adjustment for sex, age, body mass index (BMI), and physical activity, PIR was associated with prevalent (OR: 2.24; 95% CI 1.81 to 2.77; p<0.001) and incident T2D (OR: 1.66; 95% CI 1.26 to 2.17; p<0.001). PIR was associated with fasting glucose (β per SD: 0.11±0.02; p<0.001) and HbA1c (β: 0.21±0.02; p<0.001). However, PIR was not positively associated with other components of the metabolic syndrome and was even inversely associated with waist circumference (β: −0.22±0.03; p<0.001), BMI (β: −0.11±0.03; p<0.001) and homeostatic model assessment of insulin resistance (β: −0.22±0.02; p<0.001). PIR was not significantly associated with the intima-media thickness (IMT), decline of kidney function, incident albuminuria, myocardial infarction, stroke, cardiovascular or all-cause mortality.ConclusionsIn the KORA F4/FF4 cohort, PIR was positively associated with prevalent and incident T2D, but inversely associated with waist circumference, BMI and insulin resistance, suggesting that PIR might serve as a biomarker for T2D risk independently of the metabolic syndrome, but not for microvascular or macrovascular complications.

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Development and validation of a predictive model for incident type 2 diabetes in middle-aged Mexican adults: the metabolic syndrome cohort

BMC Endocrine Disorders ◽

10.1186/s12902-019-0361-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 15

Author(s):

Olimpia Arellano-Campos ◽

Donaji V. Gómez-Velasco ◽

Omar Yaxmehen Bello-Chavolla ◽

Ivette Cruz-Bautista ◽

Marco A. Melgarejo-Hernandez ◽

...

Keyword(s):

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Predictive Model ◽

Middle Aged ◽

Incident Type ◽

The Metabolic Syndrome ◽

Incident Type 2 Diabetes ◽

Mexican Adults ◽

Development And Validation

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The Metabolic Syndrome Defined by Factor Analysis and Incident Type 2 Diabetes in a Chinese Population With High Postprandial Glucose

Diabetes Care ◽

10.2337/diacare.27.10.2429 ◽

2004 ◽

Vol 27 (10) ◽

pp. 2429-2437 ◽

Cited By ~ 56

Author(s):

J.-j. Wang ◽

Q. Qiao ◽

M. E. Miettinen ◽

J. Lappalainen ◽

G. Hu ◽

...

Keyword(s):

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Factor Analysis ◽

Chinese Population ◽

Postprandial Glucose ◽

Incident Type ◽

The Metabolic Syndrome ◽

Incident Type 2 Diabetes

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Comparison of Accuracy of Diabetes Risk Score and Components of the Metabolic Syndrome in Assessing Risk of Incident Type 2 Diabetes in Inter99 Cohort

PLoS ONE ◽

10.1371/journal.pone.0022863 ◽

2011 ◽

Vol 6 (7) ◽

pp. e22863 ◽

Cited By ~ 8

Author(s):

Tracy B. Shafizadeh ◽

Edward J. Moler ◽

Janice A. Kolberg ◽

Uyen Thao Nguyen ◽

Torben Hansen ◽

...

Keyword(s):

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Risk Score ◽

Diabetes Risk ◽

Incident Type ◽

The Metabolic Syndrome ◽

Incident Type 2 Diabetes ◽

Diabetes Risk Score

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The effects of metformin plus sulfonylurea therapy on clinical features of the metabolic syndrome

Medicinski pregled ◽

10.2298/mpns1010611k ◽

2010 ◽

Vol 63 (9-10) ◽

pp. 611-615 ◽

Cited By ~ 1

Author(s):

Branka Koprivica ◽

Teodora Beljic-Zivkovic ◽

Tatjana Ille

Keyword(s):

Insulin Resistance ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Body Mass Index ◽

Waist Circumference ◽

Glycemic Control ◽

Body Mass ◽

Combined Therapy

Introduction. Insulin resistance is a well-known leading factor in the development of metabolic syndrome. The aim of this study was to evaluate metabolic effects of metformin added to sulfonylurea in unsuccessfully treated type 2 diabetic patients with metabolic syndrome. Material and methods. A group of thirty subjects, with type 2 diabetes, secondary sulfonylurea failure and metabolic syndrome were administered the combined therapy of sulfonylurea plus metformin for six months. Metformin 2000 mg/d was added to previously used sulfonylurea agent in maximum daily dose. Antihypertensive and hypolipemic therapy was not changed. The following parameters were assessed at the beginning and after six months of therapy: glycemic control, body mass index, waist circumference, blood pressure, triglycerides, total cholesterol and its fractions, homeostatic models for evaluation of insulin resistance and secretion (HOMA R, HOMA B) and C- peptide. Results. Glycemic control was significantly improved after six months of the combined therapy: (fasting 7.89 vs. 10.61 mmol/l. p<0.01; postprandial 11.12 vs. 12.61 mmol/l. p<0.01, p<0.01; glycosylated hemoglobin 6.81 vs. 8.83%. p<0.01). the body mass index and waist circumference were significantly lower (26.7 vs. 27.8 kg/m2, p<0.01 and 99.7 vs. 101.4 cm for men, p<0.01; 87.2 vs. 88.5 for women, p<0.01). Fasting plasma triglycerides decreased from 3.37 to 2.45 mmol/l (p<0.001) and HOMA R from 7.04 to 5.23 (p<0.001). No treatment effects were observed on blood pressure, cholesterol, and residual insulin secretion. Conclusion. Administration of metformin in type 2 diabetes with metabolic syndrome decreased cardiovascular risk factors by reducing glycemia, triglycerides, BMI, central obesity and insulin resistance.

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Food Intake Patterns Associated With Incident Type 2 Diabetes: The Insulin Resistance Atherosclerosis Study

Diabetes Care ◽

10.2337/dc08-1325 ◽

2008 ◽

Vol 32 (2) ◽

pp. 263-268 ◽

Cited By ~ 66

Author(s):

A. D. Liese ◽

K. E. Weis ◽

M. Schulz ◽

J. A. Tooze

Keyword(s):

Insulin Resistance ◽

Type 2 Diabetes ◽

Food Intake ◽

Incident Type ◽

Incident Type 2 Diabetes ◽

Insulin Resistance Atherosclerosis Study ◽

Food Intake Patterns

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A szexuális funkciózavar és a metabolikus szindróma kapcsolata

Orvosi Hetilap ◽

10.1556/650.2019.31235 ◽

2019 ◽

Vol 160 (3) ◽

pp. 98-103 ◽

Cited By ~ 3

Author(s):

Márta Zsoldos ◽

Attila Pajor ◽

Henriette Pusztafalvi

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Metabolic Syndrome ◽

Sexual Dysfunction ◽

The Metabolic Syndrome ◽

Atherogenic Lipid Profile ◽

Arousal Response ◽

Atherogenic Lipid

Abstract: The prevalence of the metabolic syndrome, type 2 diabetes mellitus, cardiovascular diseases, obesity and depression have increased during the recent years. As the sexual dysfunction is also frequent, we aimed to search for the associations between sexual dysfunction and the metabolic syndrome and its components, respectively, by reviewing the literature. The clinical and biochemical components of the metabolic syndrome included cardiovascular disease, type 2 diabetes mellitus, visceral obesity and depression, furthermore, insulin resistance, atherogenic lipid profile, hypogonadism, chronic systemic inflammation and endothelial dysfunction were all demonstrated to affect adversely the sexual function. The dysfunction of the sexual arousal response shows a strong association in men and a milder one in women with the cardiovascular diseases and depression. Sexual function in diabetes mellitus is mostly impaired by microvascular injury, polyneuropathy and autonomic neuropathy. Erectile dysfunction and disorder of the female sexual arousal response and the orgasm, respectively, are associated with insulin resistance, atherogenic lipid profile and systemic inflammatory condition in overweight or obese patients. Sexual dysfunction particularly in men can be an early sign of the severe complications of metabolic syndrome. The pathogenetic link between the metabolic syndrome and the sexual dysfunction seems to be the insulin resistance. Both metabolic syndrome and sexual dysfunction can be restored by altering the lifestyle. Orv Hetil. 2019; 160(3): 98–103.

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