title: The evolution of non-diabetic hyperglycemia: a longitudinal study.
abstract: The risk factors for impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) have yet to be established. Our aim was to elucidate the predisposing factors for IFG and IGT in Japanese subjects with normal glucose tolerance (NGT). Using a 75 g oral glucose tolerance test (OGTT), we analyzed 604 adults with the ADA-defined NGT. Follow-up glucose tolerance status was determined by 75 g OGTT performed 3.7 yrs later. Glucose-stimulated insulin secretion (GSIS), whole body insulin sensitivity (SI) and beta cell function (BCF) were estimated by Stumvoll indices, ISI(Matsuda), and a product of Stumvoll 1(st) and ISI(Matsuda), respectively, and hepatic SI by quantitative insulin sensitivity check index. Logistic regression analysis revealed that attenuated BCF due to low GSIS was an independent risk factor for IFG. Low whole body SI was an additional risk for IGT. Male gender and high BMI were independently related to the progression to both IFG and IGT, whereas a positive diabetes family history was independently related to IGT. The worsening of glucose tolerance at large was predicted with 66% sensitivity by risk engine with GSIS, whole body SI, gender, BMI and glucose. This finding may help when implementing early intervention strategies for diabetes.
authors.affiliation: Department of Internal Medicine, Hokuriku Central Hospital, Toyama, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Oka
authors.forename: Kunimasa
authors.initials: K
authors.lastname: Yagi
authors.forename: Kenshi
authors.initials: K
authors.lastname: Hayashi
authors.forename: Masa-aki
authors.initials: MA
authors.lastname: Kawashiri
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamada
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fumisawa
authors.forename: Keishi
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Toru
authors.initials: T
authors.lastname: Aizawa
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000517:prevention & control; D005215:Fasting; D005260:Female; D018149:Glucose Intolerance / Q000209:etiology; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology* / Q000503:physiopathology; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000502:physiology; D007564:Japan; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D001786:Blood Glucose; D007328:Insulin