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. 2016 Sep 20;8(1):104-111.
doi: 10.1007/s13340-016-0287-6. eCollection 2017 Mar.

Impact of metabolic syndrome on the incidence of type 2 diabetes in middle-aged Japanese individuals with impaired insulin secretion: the Saku study

Akiko Morimoto  1 , Yukako Tatsumi  2 , Nao Sonoda  3 , Naomi Miyamatsu  1 , Tetsuo Shimoda  4 , Shiro Sakaguchi  4
Affiliations

Impact of metabolic syndrome on the incidence of type 2 diabetes in middle-aged Japanese individuals with impaired insulin secretion: the Saku study

Akiko Morimoto et al. Diabetol Int. .

Abstract

Aims: To assess the impact of metabolic syndrome (MetS) on the incidence of type 2 diabetes in middle-aged Japanese individuals with impaired insulin secretion (IIS).

Methods: This cohort study included 1,702 individuals aged 40-59 without diabetes at baseline who underwent a comprehensive medical check-up between April 2008 and March 2009 at Saku Central Hospital. Participants were classified according to their IIS and insulin resistance (IR) status [normal, isolated IR (i-IR), or isolated IIS (i-IIS)] and MetS (presence or absence). They were followed up until March 2014. Type 2 diabetes was defined based on fasting and 2-h post-load plasma glucose concentrations and by the receipt of medical treatment for diabetes.

Results: During 7,572 person-years of follow-up, 92 individuals developed type 2 diabetes. The incidence rates (/1,000 person-years) for type 2 diabetes in the normal without MetS, normal with MetS, i-IR without MetS, i-IR with MetS, i-IIS without MetS, and i-IIS with MetS groups were 5.3, 3.7, 11.3, 24.7, 16.7, and 59.5, respectively. The multivariable-adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) for type 2 diabetes in the normal with MetS, i-IR with MetS, and i-IIS with MetS groups, relative to the normal without MetS group, were 0.52 (0.12-2.25), 3.78 (1.93-7.42), and 7.94 (3.96-15.91), respectively. Additionally, a positive association of MetS with type 2 diabetes was observed in the i-IIS group [HR (95 % CI) 3.56 (1.88-6.73)] but not in the normal and i-IR groups.

Conclusions: The prevention of MetS is important, particularly in individuals with low insulin secretion.

Keywords: Impaired insulin secretion; Metabolic syndrome; Middle age; Type 2 diabetes.

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Conflict of interest statement

The authors declare that they have no conflict of interest.All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revisions. Informed consent or a substitute for it was obtained from all participants before they were included in the study.

Figures

Fig. 1
Fig. 1
Diabetes-free survival curves according to the combination of IIS and IR status (normal, i-IR, or i-IIS) and presence or absence of MetS. Adjusted for age, sex, family history of diabetes (yes or no), smoking status (nonsmoker, ex-smoker, or current smoker), alcohol consumption (0 g/week, 1–139 g/week, or ≥140 g/week), and exercise (≥2 times/week or <2 times/week). i-IR isolated insulin resistance, i-IIS isolated impaired insulin secretion, MetS metabolic syndrome
Fig. 2a–c
Fig. 2a–c
Multivariable-adjusted hazard ratios for the incidence of type 2 diabetes according to presence or absence of MetS in the normal (a-1, 2, 3, and 4), i-IR (b-1, 2, 3, and 4), and i-IIS (c-1, 2, 3, and 4) groups. Adjusted for age, sex, family history of diabetes (yes or no), smoking status (nonsmoker, ex-smoker, or current smoker), alcohol consumption (0 g/week, 1–139 g/week, or ≥140 g/week), and exercise (≥2 times/week or <2 times/week). i-IR isolated insulin resistance, i-IIS isolated impaired insulin secretion, MetS metabolic syndrome
See this image and copyright information in PMC

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