title: Population impact of increased body mass index and attenuated beta-cell function on worsening of glucose metabolism in subjects with normal glucose tolerance: a pilot study.
abstract: The population attributable fraction (PAF) of risk factors for the worsening of glucose metabolism in subjects with normal glucose tolerance (NGT) has not been calculated. Our aim was to obtain the PAF of increased body mass index (BMI) and attenuated beta-cell function (BCF) on worsening of glucose metabolism in subjects with NGT. We longitudinally analyzed 604 Japanese adults. The follow-up glucose tolerance status was determined 3.7 years later: 430 participants remained in the NGT category and 102 had progressed to impaired fasting glucose, 67 to impaired glucose tolerance, and 5 to diabetes mellitus. A product of ISIMatsuda and Stumvoll-1, i.e., oral disposition index (DIO), was used as a measure of BCF. The optimal cutoff baseline BMI and DIO values for the prediction of the worsening of glucose metabolism were > 23.1 and < 7.299 kg/m(2), respectively. Isolated increased BMI (iBMIHIGH), isolated low DI (iDIOLOW), and "BMIHIGH and DIOLOW (BMIHIGH/DIOLOW)" were all independently related to the worsening, and the PAF values (95 % CI) for worsening due to iBMIHIGH, iDIOLOW, and BMIHIGH/DIOLOW were 12.9 (3.2-18.4) %, 10.9 (5.0-13.9) %, and 31.4 (22.7-36.3) %, respectively. As much as 55 % of the worsening of glucose metabolism in the NGT subjects was attributable to increased BMI and/or attenuated BCF. The optimal cutoff for BMI was as low as 23.1 kg/m(2) in this population. We believe that these data should form the basis of future public health strategies for the prevention of diabetes in Japan.
authors.affiliation: Diabetes Center, Aizawa Hospital, 2-5-1 Honjo, Matsumoto, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Yamauchi
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: Takuro
authors.initials: T
authors.lastname: Shimbo
authors.forename: Toru
authors.initials: T
authors.lastname: Aizawa
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D005260:Female; D018149:Glucose Intolerance / Q000175:diagnosis / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism; D050417:Insulin-Secreting Cells / Q000378:metabolism*; D007564:Japan; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D018571:Sentinel Surveillance
chemical_list: D001786:Blood Glucose; D007328:Insulin