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Factors associated with regression from prediabetes to normal glucose tolerance in a Korean general population: A community-based 10-year prospective cohort study.
Diabet Med 2018; 35(11):1544-1551DM

Abstract

AIM

A proportion of people with prediabetes convert back to normal glucose tolerance. We sought to determine the clinical variables associated with conversion from prediabetes to normal glucose tolerance, with a focus on insulin secretory capacity, insulin sensitivity and body composition.

METHODS

We followed 1731 people with prediabetes at baseline from the Korean Genome and Epidemiology Study every 2 years for 10 years. Oral glucose tolerance tests (OGTT) were performed, and muscle and fat mass were estimated using bioelectrical impedance analysis.

RESULTS

During 10 years of follow-up, 36% (623/1731) of people with prediabetes converted to normal glucose tolerance. Higher baseline fasting glucose, 2-h OGTT glucose and triglyceride levels were inversely associated with this conversion. Higher 60-min insulinogenic index (IGI60 ) at baseline was independently associated with this conversion [HR per sd (95% CI) 1.09 (1.02-1.17); P = 0.01]. However, other indices reflecting insulin sensitivity, including the composite insulin sensitivity index, were not associated with this conversion. In addition, a higher baseline muscle to fat ratio was independently associated with conversion to normal glucose tolerance [HR per sd (95% CI) 1.15 (1.04-1.26); P = 0.005]. People with conversion to normal glucose tolerance showed a greater increase in the 60-min insulinogenic index and disposition index and a smaller decrease in the composite insulin sensitivity index compared with people without conversion during 10 years of follow-up (all p-values < 0.001).

CONCLUSION

A higher insulin secretory capacity at baseline and during follow-up and higher baseline muscle to fat ratio were independently associated with an improvement in glucose tolerance in Korean adults with prediabetes.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30063816

Citation

Hwang, Y-C, et al. "Factors Associated With Regression From Prediabetes to Normal Glucose Tolerance in a Korean General Population: a Community-based 10-year Prospective Cohort Study." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 35, no. 11, 2018, pp. 1544-1551.
Hwang YC, Cho IJ, Jeong IK, et al. Factors associated with regression from prediabetes to normal glucose tolerance in a Korean general population: A community-based 10-year prospective cohort study. Diabet Med. 2018;35(11):1544-1551.
Hwang, Y. C., Cho, I. J., Jeong, I. K., Ahn, K. J., & Chung, H. Y. (2018). Factors associated with regression from prediabetes to normal glucose tolerance in a Korean general population: A community-based 10-year prospective cohort study. Diabetic Medicine : a Journal of the British Diabetic Association, 35(11), pp. 1544-1551. doi:10.1111/dme.13789.
Hwang YC, et al. Factors Associated With Regression From Prediabetes to Normal Glucose Tolerance in a Korean General Population: a Community-based 10-year Prospective Cohort Study. Diabet Med. 2018;35(11):1544-1551. PubMed PMID: 30063816.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with regression from prediabetes to normal glucose tolerance in a Korean general population: A community-based 10-year prospective cohort study. AU - Hwang,Y-C, AU - Cho,I-J, AU - Jeong,I-K, AU - Ahn,K J, AU - Chung,H Y, Y1 - 2018/08/13/ PY - 2018/07/27/accepted PY - 2018/8/1/pubmed PY - 2019/2/13/medline PY - 2018/8/1/entrez SP - 1544 EP - 1551 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 35 IS - 11 N2 - AIM: A proportion of people with prediabetes convert back to normal glucose tolerance. We sought to determine the clinical variables associated with conversion from prediabetes to normal glucose tolerance, with a focus on insulin secretory capacity, insulin sensitivity and body composition. METHODS: We followed 1731 people with prediabetes at baseline from the Korean Genome and Epidemiology Study every 2 years for 10 years. Oral glucose tolerance tests (OGTT) were performed, and muscle and fat mass were estimated using bioelectrical impedance analysis. RESULTS: During 10 years of follow-up, 36% (623/1731) of people with prediabetes converted to normal glucose tolerance. Higher baseline fasting glucose, 2-h OGTT glucose and triglyceride levels were inversely associated with this conversion. Higher 60-min insulinogenic index (IGI60 ) at baseline was independently associated with this conversion [HR per sd (95% CI) 1.09 (1.02-1.17); P = 0.01]. However, other indices reflecting insulin sensitivity, including the composite insulin sensitivity index, were not associated with this conversion. In addition, a higher baseline muscle to fat ratio was independently associated with conversion to normal glucose tolerance [HR per sd (95% CI) 1.15 (1.04-1.26); P = 0.005]. People with conversion to normal glucose tolerance showed a greater increase in the 60-min insulinogenic index and disposition index and a smaller decrease in the composite insulin sensitivity index compared with people without conversion during 10 years of follow-up (all p-values < 0.001). CONCLUSION: A higher insulin secretory capacity at baseline and during follow-up and higher baseline muscle to fat ratio were independently associated with an improvement in glucose tolerance in Korean adults with prediabetes. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/30063816/Factors_associated_with_regression_from_prediabetes_to_normal_glucose_tolerance_in_a_Korean_general_population:_A_community_based_10_year_prospective_cohort_study_ L2 - https://doi.org/10.1111/dme.13789 DB - PRIME DP - Unbound Medicine ER -