title: Fasting insulin level underestimates risk of non-insulin-dependent diabetes mellitus due to confounding by insulin secretion.
abstract: Fasting insulin has been used as a surrogate measure of insulin sensitivity in studies of non-insulin-dependent diabetes mellitus (NIDDM) risk, but the fasting insulin-NIDDM association may be confounded by insulin secretion, which correlates negatively with NIDDM risk and positively with fasting insulin level. In a prospective 5-year study of 137 nondiabetic Japanese-American men in King County, Washington State, higher fasting insulin was not strongly related to NIDDM (odds ratio (OR) = 1.37, 95% confidence interval (CI) 0.80-2.34), but this odds ratio increased substantially after adjustment for insulin secretion (OR = 2.92, 95% CI 1.41-6.06). Research on NIDDM risk in relation to fasting insulin may yield biased effect measures unless adjusted for insulin secretion.
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Boyko
authors.forename: D L
authors.initials: DL
authors.lastname: Leonetti
authors.forename: R W
authors.initials: RW
authors.lastname: Bergstrom
authors.forename: W Y
authors.initials: WY
authors.lastname: Fujimoto
mesh_terms: D001213:Asian; D015982:Bias; D001786:Blood Glucose; D002096:C-Peptide / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005215:Fasting / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000097:blood* / Q000378:metabolism*; D000078790:Insulin Secretion; D007564:Japan / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014861:Washington
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin