title: Serum insulin, insulin resistance, beta-cell dysfunction, and gallstone disease among type 2 diabetics in Chinese population: a community-based study in Kinmen, Taiwan.
abstract: OBJECTIVE
  To explore the association of serum insulin, insulin resistance, and beta-cell dysfunction with gallstone disease (GSD) in type 2 diabetics.
  
  
  METHODS
  We used a community-based study conducted between 1991 and 1993 in Kinmen, Taiwan to identify type 2 diabetics. A screening program for GSD was performed in 2001 by a panel of specialists who employed real-time ultrasound sonography to examine the abdominal region after the patient had fasted for at least 8 h. Screening was conducted in 2001 on 848 patients diagnosed with type 2 diabetes. The HOMA method was used to compare the profile differences for insulin resistance (HOMA IR) and beta-cell dysfunction (HOMA beta-cell).
  
  
  RESULTS
  We studied 440 type 2 diabetics who attended sonography check-ups. After excluding eight insulin-treated diabetics, the prevalence of GSD among the remaining 432 was 13.9% (26/187) among males and 14.7% (36/245) among females. After adjustment for other GSD-associated risk factors in addition to age and obesity, GSD risk increased among females with levels of serum insulin [4(th) vs 1(st) quartile odds ratios (OR) = 4.46 (95%CI: 1.71-11.66)] and HOMA IR [4(th) vs 1(st) quartile OR = 4.46 (95%CI: 1.71-11.66)]. Better HOMA beta-cell function was significantly related to decreased risk of GSD [4(th) vs 1(st) quartile OR = 0.16 (95%CI: 0.03-1.70)]. Among males, age and central obesity were the most significant risk factors for GSD. No association of GSD with serum insulin, HOMA IR, and HOMA beta-cell was observed among males.
  
  
  CONCLUSIONS
  Serum insulin, insulin resistance, and beta-cell dysfunction are risk factors for GSD in females, but not males with type 2 diabetes.
authors.affiliation: Community Medicine Research Center, National Yang-Ming University, Shih-Pai, 112 Taipei, Taiwan, China.
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Liu
authors.forename: Tao-Hsin
authors.initials: TH
authors.lastname: Tung
authors.forename: Shih-Tzer
authors.initials: ST
authors.lastname: Tsai
authors.forename: Jorn-Hon
authors.initials: JH
authors.lastname: Liu
authors.forename: Yeh-Kuang
authors.initials: YK
authors.lastname: Tsai
authors.forename: Victor Tze-Kai
authors.initials: VT
authors.lastname: Chen
authors.forename: Tseng-Nip
authors.initials: TN
authors.lastname: Tam
authors.forename: Hsu-Feng
authors.initials: HF
authors.lastname: Lu
authors.forename: Kuang-Kuo
authors.initials: KK
authors.lastname: Wang
authors.forename: Chung-Te
authors.initials: CT
authors.lastname: Hsu
authors.forename: Hui-Chuan
authors.initials: HC
authors.lastname: Shih
authors.forename: De-Chuan
authors.initials: DC
authors.lastname: Chan
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007515:Islets of Langerhans / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D007328:Insulin