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- Title
Proinsulin/Insulin (PI/I) Ratio Increases with Worsening Hyperglycemia and Diminishing β-cell Function, But Is Not Related to Severity of Insulin Resistance in Patients with Type 2 Diabetes (T2DM).
- Authors
Sanchez, Matilde; Mei Wu; Stein, Peter
- Abstract
In patients (pts) with T2DM, an increase in the PI/I ratio may reflect β-cell dysfunction associated with the disease. In this analysis, relationships between the PI/I ratio and parameters reflecting glucose homeostasis were examined in a wide range of pts with T2DM. From a sample of 3091 pts from different clinical studies (A1C: 6.5-11%), baseline measures of fasting and postprandial glycemic control, fasting insulin secretion (HOMA-β), and insulin resistance (HOMA-IR and QUICKI) were correlated with the PI/I ratio to identify factors that impact this ratio. Mean age was 54 yrs, 55% were male, and mean duration of T2DM was 5.3 years. Mean A1C was 8.3%, FPG 186 mg/dL, and PI/I ratio 0.44 (normal <0.20). At screening, 32% of pts were not on oral AHA, 54% were on monotherapy, and 14% were on combination therapy. The correlations with PI/I ratio described below were generally similar regardless of current therapy. Males had higher PI/I ratio than females. Age did not correlate, but duration of diabetes was positively correlated with the PI/I ratio (Table). The ratio increased with worsening hyperglycemia (i.e. higher A1C, FPG, and 2-hr PPG). Increased HOMA-β was associated with a lower PI/I ratio. Fasting and postprandial insulin levels were negatively correlated with the PI/I ratio. There was no relationship between the ratio and measures of insulin resistance, HOMA-IR or QUICKI. In summary, the PI/I ratio was elevated in this large cohort of pts with T2DM. The ratio was higher with longer duration of diabetes, severity of hyperglycemia and with diminishing fasting insulin secretion, but was not related to markers of insulin resistance supporting the concept that β-cell dysfunction is an independent core pathophysiology.
- Publication
Diabetes, 2007, Vol 56, pA158
- ISSN
0012-1797
- Publication type
Academic Journal