The association of the insulin resistance syndrome with impaired glucose tolerance and NIDDM in the Japanese general population: the Hisayama study.
To elucidate the risk factors for initiating glucose intolerance, the relevant factors were explored in a cross-sectional survey conducted in a sample population aged 40-79 years old selected from a Japanese community, Hisayama, Japan in 1988. A 75-g oral glucose tolerance test was used to classify 1,073 men (72.5% of the entire population in the same age range) and 1,407 women (80.5%) into normal, impaired glucose tolerance and diabetes mellitus groups. In all age and sex groups with normal glucose tolerance, the sum of fasting and 2-h post-load insulin values varied widely and demonstrated significant positive correlations with triglycerides, body mass index, waist-hip ratio, systolic and diastolic blood pressure, while it negatively correlated to HDL cholesterol (p < 0.05). Insulin resistance was presumed to develop in normal glucose tolerance subjects with hyperinsulinaemia. The sum of the insulin concentrations, triglycerides, body mass index, waist-hip ratio and blood pressure levels was significantly associated with impaired glucose tolerance in all age and sex groups after adjustment for age (p < 0.05) and was also related to diabetes in either all or some age and sex groups, respectively (p < 0.05). It was shown that glucose intolerance in the general population was associated with the factors related to insulin resistance. These cross-sectional data, therefore, support the hypothesis that insulin resistance is the primary defect in the development of glucose intolerance in the Japanese general population. However, a further prospective study is still needed in order to confirm this hypothesis.
Ohmura
T
T
Second Department of Internal Medicine, Faculty of Medicine Kyushu University, Fukuoka, Japan.
Ueda
K
K
Kiyohara
Y
Y
Kato
I
I
Iwamoto
H
H
Nakayama
K
K
Nomiyama
K
K
Ohmori
S
S
Yoshitake
T
T
Shinkawa
A
A
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol