title: Difference between old and young adults in contribution of β-cell function and sarcopenia in developing diabetes mellitus.
abstract: To investigate the difference in contributing factors in developing diabetes between old and young adults.
  
  
  
  Subjects with recent-onset diabetes were selected from a nationwide survey data and classified according to age: elderly (age ≥75 years), middle-age (age 45-64 years) and young (age 25-39 years). The homeostasis model assessment of insulin resistance and β-cell function were calculated. Sarcopenia was assessed using dual-energy X-ray absorptiometry.
  
  
  
  The prevalence of recent-onset diabetes was 13.5%, 8.0%, and 1.4% in patients aged ≥75 years (unweighted n = 1,082), 45-64 years (unweighted n = 6,532), and 25-39 years (unweighted n = 5,178), respectively. Homeostasis model assessment of β-cell function along with homeostasis model assessment of insulin resistance showed increasing trends as onset age increased in recent-onset diabetes (P for trend < 0.001 in both). Elderly-onset diabetic patients had significantly higher homeostasis model assessment of β-cell function and homeostasis model assessment of insulin resistance compared with the middle-age-onset group (P < 0.001 and 0.014, respectively). Multivariate analysis showed that sarcopenia was significantly associated with recent-onset diabetes only in patients aged ≥75 years (odds ratio [OR] 2.478, 95% confidence interval [CI] 1.379-4.452) but not in patients aged 45-64 years. In the middle-age group, abdominal obesity (OR 2.933, 95% CI 2.086-4.122), hypertriglyceridemia (OR 1.529, 95% CI 1.078-2.169]) and low high-density lipoprotein cholesterolemia (OR 1.930, 95% CI 1.383-2.695) were associated with recent-onset diabetes.
  
  
  
  Elderly-onset diabetic patients had higher insulin resistance and relatively preserved β-cell function compared with middle-age-onset patients. Sarcopenia might play a more important role in developing diabetes in the elderly population.
authors.affiliation: Department of Internal Medicine Seoul National University College of Medicine Seoul Korea; Department of Internal Medicine Boramae Medical Center Seoul Korea.
authors.forename: Bo Kyung
authors.initials: BK
authors.lastname: Koo
authors.affiliation: Department of Internal Medicine Seoul National University College of Medicine Seoul Korea; Department of Medicine University of Ulsan College of Medicine Seoul Korea.
authors.forename: Eun
authors.initials: E
authors.lastname: Roh
authors.affiliation: Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.
authors.forename: Ye Seul
authors.initials: YS
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine Seoul National University College of Medicine Seoul Korea; Department of Internal Medicine Boramae Medical Center Seoul Korea.
authors.forename: Min Kyong
authors.initials: MK
authors.lastname: Moon
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000502:physiology*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055948:Sarcopenia / Q000150:complications*
keywords: Diabetes mellitus; Pancreatic β‐cells; Sarcopenia