Author(s): YUE Yu, HE Hua, YANG Xiao-jie, ZHANG Xiang-xun, CHEN Da-wei, WANG Chun, LIU Guan-jian, RAN Xing-wu, Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Department of Endocrinology and Metabolism, West China Hospital Chengban Branch, Sichuan University, Department of Endocrinology and Metabolism, Chengdu Second People’s Hospital, Laboratory of Endocrinology and Metabolism, West China Hospital, Sichuan University, The Cochrane Center of China
Pages: 790-795
Year: 2016 Issue:  5
Journal: Journal of Sichuan University(Medical Science Edition)
Keyword:  β-cell function; Prediabetes; Type 2 diabetes mellitus; Area-under-curve of glucose; Continuous glucose monitoring;
Abstract: Objective To compare the pancreaticβ-cell functions of Han people between those with normal glucose tolerance(NGT),prediabetes(PD),and newly-diagnosed type 2diabetes mellitus(NDDM),and to evaluate the value of the continuous glucose monitoring system(CGMS)in determiningβ-cell functions.Methods A total of169 volunteers of Han people(20-75 years old,72 male and 97female)without diagnosed diabetes were given 75-g oral glucose tolerance test(OGTT)and insulin release tests.The body mass index(BMI)of the participants ranged from 18.5to 28.0kg/m2.They were categorized into NGT(n=87),PD(n=52)and NDDM(n=30)groups according to the World Health Organization(WHO)1999criteria.Blood samples were taken to test triglyceride(TG),total cholesterol(TC),and glycosylated hemoglobin A1c(HbA1c).The participants were also given a 72 h continuous glucose monitoring.Theβ-cell functions were calculated using the OGTT and insulin release test results,which included homeostasis model assessment insulin resistance(HOMA-IR),homeostasis model assessmentβ-cell function(HOMA-B),basic secretion,early phase secretion,and second phase secretion.The area under the curve of glucose(AUC-G)was estimated through the CGMS.A multivariate stepwise regression model was developed to identify predictors ofβ-cell functions.Results Significant differences in age,BMI,HOMA-IR,HOMA-B,AUC-G,basic secretion,early phase secretion and second phase secretion were found between the NGT and PD groups(P<0.05)and between the NGT and NDDM groups(P<0.05).Differences in AUC-G and basic secretion and early phase secretion were found between the PD and NDDM groups(P<0.05),but not in age,BMI,HOMA-IR,HOMA-B,and second phase secretion.The multivariate stepwise regression analysis showed that HOMA-B(standardized partical regression coefficientβ=-0.244,P=0.001),basic secretion(β=-0.355,P<0.001),and HbA1c(β=0.638,P<0.001)contributed significantly to the AUC-G.Conclusion β-cell functions decline in those with prediabetes,which appears first at the second phase secretion.Changes inβ-cell secretion functions are more obvious than in insulin resistance during the progression from PD to NDDM.AUC-G can be a better indicator of impairedβ-cellfunctions.