Insulin Resistance and the Risk of Diabetes and Dysglycemia in Korean General Adult Population

Baek, Jong Ha; Kim, Hosu; Kim, Kyong Young; Jung, Jaehoon

doi:10.4093/dmj.2017.0106

Cited by 31 publications

(28 citation statements)

References 35 publications

(40 reference statements)

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“…Interestingly, the AUC of the surrogate measures differed by sex. This result is consistent with those of a previous study [ 17 , 19 ]. Considering that estrogens promote peripheral fat storage, whereas androgens promote the accumulation of visceral abdominal fat, the alteration of sex hormone might affect the insulin resistance and the diagnostic performance of each measure for type 2 DM [ 37 ].…”

Section: Discussionsupporting

confidence: 94%

“…However, the AUC value was much lower than those in previous studies. According to studies conducted in Iran, China, and Korea, the AUC value of HOMA-IR was approximately 0.7–0.8 [ 17 – 19 ]. Interestingly, a significant decline of the diagnostic performance of HOMA-IR for type 2 DM was observed with aging [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…According to studies conducted in Iran, China, and Korea, the AUC value of HOMA-IR was approximately 0.7–0.8 [ 17 – 19 ]. Interestingly, a significant decline of the diagnostic performance of HOMA-IR for type 2 DM was observed with aging [ 19 ]. Several previous studies showed a decline in the AUC of HOMA-IR for metabolic syndrome in elderly individuals as well [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

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The cut-off values of surrogate measures for insulin resistance in the Korean population according to the Korean Genome and Epidemiology Study (KOGES)

et al. 2018

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ObjectiveThe current methods available for determining insulin resistance are complicated; hence, they are only applicable to small-scale studies. Therefore, this study aimed to classify the characteristics of surrogate measures for insulin resistance and establish valid cut-off values for predicting the development of type 2 diabetes mellitus (DM) in Korean populations.MethodsThis prospective study included 7,643 participants aged 40–69 years from the Ansung-Ansan cohort database (2001–2012). Four surrogate measures, namely homeostasis model assessment-insulin resistance (HOMA-IR), visceral adiposity index (VAI), lipid accumulation product (LAP), and triglycerides and glucose (TyG) index, were analyzed. We analyzed each measure using receiver operating characteristic (ROC) curve for the development of type 2 DM. The cut-off value was determined as the value with the highest Youden index score in the specificity dominant area.ResultsThe area under the curve (AUC) was 0.566 (95% confidence interval [CI], 0.548–0.583) for HOMA-IR, 0.622 (95% CI, 0.605–0.639) for VAI, 0.642 (95% CI, 0.625–0.658) for LAP, and 0.672 (95% CI, 0.656–0.687) for TyG index. The AUC of TyG index was significantly higher than that of HOMA-IR, VAI, and LAP (p < 0.001). The cut-off value was 2.54 (sensitivity 36.8%; specificity 73.1%; hazard ratio [HR], 1.41, 95% CI, 1.25–1.59) for HOMA-IR, 2.54 (sensitivity 50.4%; specificity 68.8%; HR, 1.75, 95% CI, 1.55–1.96) for VAI, 36.6 (sensitivity 59.2%; specificity 63.9%; HR, 1.87, 95% CI, 1.64–2.14) for LAP, and 4.69 (sensitivity 62.1%; specificity 63.1%; HR, 2.17, 95% CI, 1.92–2.45) for TyG index.ConclusionsThe TyG index was a better predictor for DM than HOMA-IR. VAI and LAP showed the modest predictability for DM. The TyG index could be a useful supplementary method for identifying individuals at risk for insulin resistance and DM development.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The cut-off values of surrogate measures for insulin resistance in the Korean population according to the Korean Genome and Epidemiology Study (KOGES)

et al. 2018

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“…We also found an L-shaped association between HOMA-IR and annual changes in FEV1 and FVC using the multivariate GAM plot, and the suggested threshold of HOMA-IR for lung function decline was 2.4. As a surrogate marker of insulin resistance, several studies have shown that the cutoff value of HOMA-IR for the risk of developing type 2 diabetes mellitus and metabolic syndrome in the Korean population is approximately 2.5 [22][23][24]. Our ndings, consistent with those of previous studies, indicated that a decline in lung function may be metabolic complication due to the systemic effects of insulin resistance.…”

Section: Discussionsupporting

confidence: 90%

Association between insulin resistance and lung function change: Analysis from the community-based prospective Ansan-Ansung cohort in Korea

Kim¹,

Min²,

Kim³

et al. 2020

Preprint

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Background: Diabetes mellitus and hyperglycemia are associated with respiratory dysfunction. Although several studies have reported that insulin resistance is related to decreased lung function, the association between insulin resistance and lung function changes has been rarely studied. This study aimed to investigate the effect of insulin resistance on the annual lung function change using a large-scale prospective cohort.Methods: We analyzed a community-based prospective cohort in Korea comprising 7,536 participants whose serial lung functions were assessed. Exposure was baseline insulin resistance estimated with homeostatic model assessment-insulin resistance (HOMA-IR), and outcomes were annual changes in forced expiratory volume in 1 second (FEV1), functional vital capacity (FVC), and FEV1/FVC ratio.Results: In the multivariate linear regression, the increased in the logarithmic HOMA-IR was associated with a decrease in FEV1 (β: -0.23; 95% CI: -0.32 to -0.13; P < 0.001), and FVC (β: -0.29; 95% CI: -0.39 to -0.19; P < 0.001), but not in FEV1/FVC ratio (β: 0.05; 95% CI: 0.00 to 0.11; P = 0.051). In the generalized additive model plot, L-shaped association between HOMA-IR and changes in FEV1 and FVC were observed with a HOMA-IR threshold of 2.4. Age modulated the effect of HOMA-IR on the change in FEV1, and increased HOMA-IR was associated with decreased annual FEV1 change only in the older population.Conclusions: Insulin resistance was a novel risk factor for the decrease in FEV1 and FVC. The aging process may modulate the effect of insulin resistance on the decline in lung function.

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“…While NAFLD is an independent risk factor for cardiovascular complications [19], when combined with type 2 diabetes, it further increases the risk of systemic atherosclerosis [3]. Insulin resistance, a characteristic feature of both type 2 diabetes and NAFLD, is known as the key pathophysiology linking type 2 diabetes, NAFLD, and atherosclerosis [2,20]. However, little is known about the longitudinal effects of NAFLD or NASH on systemic atherosclerosis in type 2 diabetes.…”

mentioning

confidence: 99%

Non-alcoholic steatohepatitis and progression of carotid atherosclerosis in patients with type 2 diabetes: a Korean cohort study

Lee

Cho

Choi³

et al. 2020

Cardiovasc Diabetol

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Background: There is increasing concern regarding cardiovascular risk in individuals with non-alcoholic fatty liver disease. This study was conducted to evaluate whether hepatic steatosis with or without fibrosis is associated with the progression of carotid atherosclerosis in patients with type 2 diabetes. Methods: From a longitudinal cohort, we enrolled 1120 patients with type 2 diabetes who underwent repeated carotid artery ultrasonography every 1-2 years. Ultrasonographic findings at baseline and after 6-8 years were compared. Presence of hepatic steatosis was mainly assessed by abdominal ultrasonography; patients with hepatic steatosis were further evaluated for hepatic fibrosis according to fibrosis-4 index. We investigated the association between liver status and atherosclerosis progression. Results: Of 1120 patients, 636 (56.8%) were classified as having hepatic steatosis at baseline. After 6-8 years, 431 (38.5%) showed atherosclerosis progression. Hepatic steatosis was significantly associated with atherosclerosis progression (adjusted odds ratio[AOR]: 1.370, 95% CI 1.025-1.832; p < 0.05). Among patients with hepatic steatosis, only individuals with fibrosis showed significant association with atherosclerosis progression (AOR: 1.615, 95% CI 1.005-2.598; p < 0.05). The association between hepatic fibrosis and atherosclerosis progression was significant in all metabolic subgroups regardless of age, body mass index, presence of metabolic syndrome, or insulin sensitivity (all p < 0.05). Furthermore, subjects with hepatic steatosis & fibrosis and ≥ 4 components of metabolic syndrome criteria showed markedly increased risk of atherosclerosis progression (AOR: 2.430, 95% CI 1.087-5.458; p < 0.05). Conclusions: Hepatic steatosis with fibrosis is independently associated with the progression of carotid atherosclerosis in patients with type 2 diabetes.

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Insulin Resistance and the Risk of Diabetes and Dysglycemia in Korean General Adult Population

Cited by 31 publications

References 35 publications

The cut-off values of surrogate measures for insulin resistance in the Korean population according to the Korean Genome and Epidemiology Study (KOGES)

The cut-off values of surrogate measures for insulin resistance in the Korean population according to the Korean Genome and Epidemiology Study (KOGES)

Association between insulin resistance and lung function change: Analysis from the community-based prospective Ansan-Ansung cohort in Korea

Non-alcoholic steatohepatitis and progression of carotid atherosclerosis in patients with type 2 diabetes: a Korean cohort study

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