Serum insulin, insulin resistance, beta-cell dysfunction, and gallstone disease among type 2 diabetics in Chinese population: a community-based study in Kinmen, Taiwan.
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.
Liu
Chi-Ming
CM
Community Medicine Research Center, National Yang-Ming University, Shih-Pai, 112 Taipei, Taiwan, China.
Tung
Tao-Hsin
TH
Tsai
Shih-Tzer
ST
Liu
Jorn-Hon
JH
Tsai
Yeh-Kuang
YK
Chen
Victor Tze-Kai
VT
Tam
Tseng-Nip
TN
Lu
Hsu-Feng
HF
Wang
Kuang-Kuo
KK
Hsu
Chung-Te
CT
Shih
Hui-Chuan
HC
Chan
De-Chuan
DC
Chou
Pesus
P
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
D007328:Insulin