The relative associations of beta-cell function and insulin sensitivity with glycemic status and incident glycemic progression in migrant Asian Indians in the United States: The MASALA study

• Type of Material: Article
• Authors: U.P. Gujral, Emory University; K.M. Venkat Narayan, Emory University; S.E. Kahn, VA Puget Sound Hlth Care Syst; A.M. Kanaya, University of California San Francisco
• Language: English
• Date: 2014-01-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jdiacomp.2013.10.002
• Title of Journal or Parent Work: Journal of Diabetes and its Complications
• ISSN: 1056-8727
• Volume: 28
• Issue: 1
• Start Page: 45
• End Page: 50
• Grant/Funding Information: This project was supported by NIH/NCRR UCSF-CTSI Grant Number UL1 RR024131.; UP Gujral was funded by the Fulbright Nehru Scholars Program.; SE Kahn was supported by the United States Department of Veterans Affairs.; The MASALA study was supported by the NIH [grant no. K23 HL080026-01] and the American Heart Association (Western States Affiliate award #0855069F).
• Keywords: Life Sciences & Biomedicine; GLUCOSE; SOUTH ASIANS; MODEL; beta-cell dysfunction; PREVALENCE; Type 2 diabetes mellitus; Impaired fasting glucose; Insulin sensitivity; Asian Indians; Incidence; ATHEROSCLEROSIS; DYSFUNCTION; Impaired glucose tolerance; Ethnicity; Science & Technology; US; RESISTANCE; Endocrinology & Metabolism; POPULATION-BASED INCIDENCE; RISK
• Research Categories: Biology, Cell; Health Sciences, Public Health

Abstract

Aims We assessed the relative associations of β-cell dysfunction and insulin sensitivity with baseline glycemic status and incident glycemic progression among Asian Indians in the United States. Methods A 5-sample oral glucose tolerance test was obtained at baseline. Normoglycemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes (T2DM) were defined by ADA criteria. The Matsuda Index (ISIM) estimated insulin sensitivity, and the Disposition Index (DIo) estimated β-cell function. Visceral fat was measured by abdominal CT. After 2.5 years, participants underwent a 2-sample oral glucose tolerance test. Standardized polytomous logistic regression was used to examine associations with prevalent and incident glycemia. Results Mean age was 57 ± 8 years and BMI 26.1 ± 4.6 kg/m2. Log ISIM and log DI o were associated with prediabetes and T2DM after adjusting for age, sex, BMI, family history of diabetes, hypertension, and smoking. After adjusting for visceral fat, only DIo remained associated with prediabetes (OR per SD 0.17, 95% CI: 0.70, 0.41) and T2DM (OR 0.003, 95% CI: 0.0001, 0.03). Incidence rates (per 1,000 person-years) were: normoglycemia to IGT: 82.0, 95% CI (40, 150); to IFG: 8.4, 95% CI (0, 41); to T2DM: 8.6, 95% CI (0, 42); IGT to T2DM: 55.0, 95% CI (17, 132); IFG to T2DM: 64.0, 95% CI (3, 316). The interaction between sex and the change in waist circumference (OR 1.8, per SD 95% CI: 1.22, 2.70) and the change in log HOMA-β (OR 0.37, per SD 95% CI: 0.17, 0.81) were associated with glycemic progression. Conclusions The association of DIo with baseline glycemia after accounting for visceral fat as well as the association of the change in log HOMA-β with incident glycemic progression implies innate β-cell susceptibility in Asian Indians for glucose intolerance or dysglycemia.