title: Factors associated with beta-cell dysfunction in type 2 diabetes: the BETADECLINE study.
abstract: OBJECTIVE
  Beta-cell dysfunction is an early event in the natural history of type 2 diabetes. However, its progression is variable and potentially influenced by several clinical factors. We report the baseline data of the BetaDecline study, an Italian prospective multicenter study on clinical predictors of beta-cell dysfunction in type 2 diabetes.
  
  
  METHODS
  Clinical, lifestyle, and laboratory data, including circulating levels of inflammatory markers and non-esterified fatty acids, were collected in 507 type 2 diabetic outpatients on stable treatment with oral hypoglycemic drugs or diet for more than 1 year. Beta-cell dysfunction was evaluated by calculating the proinsulin/insulin ratio (P/I).
  
  
  RESULTS
  At baseline, the subjects in the upper PI/I ratio quartile were more likely to be men and receiving secretagogue drugs; they also showed a borderline longer diabetes duration (P = 0.06) and higher serum levels of glycated hemoglobin (HbA1c), fasting blood glucose, and triglycerides. An inverse trend across all PI/I quartiles was noted for BMI and serum levels of total cholesterol (T-C), LDL-C, HDL-C and C reactive protein (CRP), and with homeostatic model assessment (HOMA-B) and HOMA of insulin resistance (HOMA-IR) values (P<0.05 for all). At multivariate analysis, the risk of having a P/I ratio in the upper quartile was higher in the subjects on secretagogue drugs (odds ratio [OR] 4.2; 95% confidence interval [CI], 2.6-6.9) and in the males (OR 1.8; 95% CI, 1.1-2.9).
  
  
  CONCLUSIONS
  In the BetaDecline study population, baseline higher PI/I values, a marker of beta-cell dysfunction, were more frequent in men and in patients on secretagogues drugs. Follow-up of this cohort will allow the identification of clinical predictors of beta-cell failure in type 2 diabetic outpatients.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
authors.forename: Giuseppina T
authors.initials: GT
authors.lastname: Russo
authors.affiliation: Metabolism and Diabetes Unit ASL TO5, Chieri, Italy.
authors.forename: Carlo Bruno
authors.initials: CB
authors.lastname: Giorda
authors.affiliation: MSD, Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Cercone
authors.affiliation: Department of Clinical Pharmacology and Epidemiology Fondazione Mario Negri Sud, S. Maria Imbaro, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Nicolucci
authors.affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Cucinotta
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology* / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011384:Proinsulin / Q000378:metabolism; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin; D011384:Proinsulin