Pathophysiologic heterogeneity in the development of type 2 diabetes mellitus in Korean subjects.
OBJECTIVE
To investigate the clinical characteristics and predisposing metabolic abnormalities in the development of glucose intolerance and diabetes mellitus in obese and non-obese Korean subjects.


METHODS
Four hundred Korean subjects were classified into five groups according to degree of glucose tolerance by OGTT: NGT, IGT alone, IFG alone, IFG+IGT, and DM. The groups were also subdivided into obese and non-obese group according to body mass index. Insulin resistance was assessed by using homeostasis model assessment of insulin resistance (HOMA-R), and insulinogenic index was used as an index of early-phase insulin secretion.


RESULTS
Impaired early-phase insulin secretion was seen in non-obese IGT alone, IFG alone, and IFG+IGT, though more profound secretory defects were noted in IFG+IGT and DM. No significant difference were found in HOMA-R among non-obese IGT alone, IFG alone, or IFG+IGT, or in terms of early-phase insulin secretion in obese IGT alone, IFG alone, or IFG+IGT. However, the magnitude of insulin resistance differed in the obese group, IFG+IGT and DM being more insulin resistant than IGT alone or IFG alone.


CONCLUSIONS
These results suggest that the predisposing metabolic abnormality in non-obese subjects with IGT alone or IFG alone and in progression to IFG+IGT might be deterioration of early phase insulin secretion, whereas insulin resistance might be the major contributory factor in obese subjects. The predisposing metabolic abnormality leading to diabetes in both obese and non-obese groups was deterioration of early-phase insulin secretion.
Kang
Hahn Wook
HW
Department of Internal Medicine, Hallym Hospital, 900-4 Jakjen-Dong, Gyeyang-Ku, Inchon, Republic of Korea. bangwookang@hanmail.net
Kim
Dong Joon
DJ
Lee
Myung-Shik
MS
Kim
Kwang-Won
KW
Lee
Moon-Kyu
MK
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005951:Glucose Tolerance Test; D006293:Health Promotion; D006706:Homeostasis; D006801:Humans; D007723:Korea; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology
D001786:Blood Glucose