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- Title
Insulin Resistance (IR) and β-Cell Dysfunction, but not Visceral Adiposity, Predict New Onset Diabetes in Hispanics (HA) and African Americans (AA): The IRAS Family Study.
- Authors
Hanley, Anthony J.; Wagenknecht, Lynne E.; Norris, Jill; Bryer-Ash, Michael; Bergman, Richard; Haffner, Steven M.
- Abstract
Central obesity, IR and β-cell dysfunction are known to be independent risk factors for the development of type 2 diabetes (DM). In most prospective studies these factors have been assessed indirectly using body circumferences and glucose and insulin measures. A few studies have utilized direct measures of individual disorders, although none to our knowledge have assessed DM incidence using detailed measures of all three. Our objective was to study the association of directly measured visceral adipose tissue (VAT), insulin sensitivity (S[sub I]) and acute insulin response (AIR) with incident DM in 1070 HA and AA subjects in the IRAS Family study who were free of DM at baseline (2000-02). S[sub I] and AIR were determined from frequently sampled IV glucose tolerance tests with minimal model analysis. VAT was determined by computed tomography. Impaired fasting glucose (IFG) and DM were defined according to ADA criteria. Generalized estimating equations were used to account for correlations within families. Incident DM was diagnosed in 85 subjects alter 5 years. After adjustment for age, sex, ethnicity, IFG and BMI, both S[sub I] (log transformed) and AIR (square root transformed) were significantly inversely associated with DM (OR=0.44 (95% CI 0.29-0.67), OR=0.18 (0.11-0.31) per SD, respectively, both p<0.001). In contrast, VAT was not associated with DM (OR = 1.18 (0.87-1.59) per SD, p=0.28) under similar adjustment. In a full model including all 3 factors, S[sub I] and AIR (OR= 0.46 (0.31-0.69), OR= 0.19 (0.11-0.32), respectively, both p<0.001) as well as IFG (OR= 2.35 (1.21-4.59), p<0.05) were significant DM predictors. Ethnicity did not modify the effect of VAT, however a significant sex by VAT interaction (p=0.04) indicated a stronger association of VAT with DM in women. In conclusion, IR and β-cell dysfunction predicted incident DM among HA and AA. While VAT was not predictive overall, there was some evidence of an effect in women.
- Publication
Diabetes, 2007, Vol 56, pA11
- ISSN
0012-1797
- Publication type
Academic Journal