Beta Cell Function, Insulin Resistance and Low Grade Systemic Inflammation in Myanmar Adults with Different Categories of Glucose Tolerance
Abstract
Objective. The aim of the study was to evaluate the beta cell function, insulin sensitivity and low grade systemic inflammation in different categories of glucose tolerance in Myanmar.
Methodology. A cross-sectional study was conducted on 202 Myanmar subjects of both sexes, aged between 45-65 years old. Fasting blood glucose, insulin, C-peptide and hs-CRP levels were measured. A 75g oral glucose tolerance test was performed. Insulin resistance and beta cell function were assessed by homeostasis-model-assessment (HOMA).
Results. The subjects were categorized as normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and diabetes mellitus (DM) according to WHO-2006 criteria. Fasting serum insulin, C-peptide and hs-CRP levels and insulin resistance index (HOMA-IR) progressively increased from NGT through prediabetes (IFG, IGT) to DM (p<0.01). Beta-cell function did not change significantly in any other group as compared to normal group.
Conclusion. After multivariate analysis, increases in fasting C-peptide, hs-CRP and HOMA-IR index were significantly associated with diabetes. It was also found that insulin resistance was a predominant feature in deterioration of the glucose tolerance in Myanmar subjects.
Downloads
References
S, Green A, Sicree R. Global prevalence of Diabetes. Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27: 1047-1053.
Kaku K. Pathophysiology of type 2 Diabetes and its treatment policy. JMJ.2010; 53: 41-46.
Yang W, LU J, Weng J, et al. For the China National Diabetes and Metabolic Disorders Study Group.Prevalence of Diabetes among men and women in China.N Engl J Med. 2010; 362: 1090-1101.
National Health Plan/Myanmar. Prevention and Control of Diabetes Mellitus, situational analysis,(2006-2011) 2-4.
Ramlo-Halsted BA, Edelman SV. The natural history of type 2 diabetes.Implications for clinical practice. Prim Care.1999; 26: 771-789.
Rao SS, Disraeli P, McGregor T. Impaired Glucose Tolerance and Impaired Fasting Glucose. Am Fam Physician. 2004; 69: 1961-1972.
Bergstrom RW, Leonetti DL, Newell-Morris LL, et al. Association of plasma triglyceride and C-peptide with coronary heart disease in Japanese-American men with a high prevalence of glucose intolerance. Diabetologia. 1990; 33: 489-496.
Matthews D, Hosker J, Rudenski A, et al. Homeostasis model assessment: insulin resistance and beta cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia.1985;28: 412–419.
Levy JC, Matthews DR, Hermans MP. Correct homeostasis model assessment (HOMA) evaluation uses the computer program (Letter). Diabetes Care. 1998; 21: 2191–2192.
Onishi Y, Hayashi T, Sato KK, et al. Fasting tests of insulin secretion and sensitivity predict future prediabetes in Japanese with normal glucose tolerance. Journal of Diabetes Investigation. 2010; 1: 191-195.
Pradhan AD, Manson JE, Rifai N, et al. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA. 2001; 286: 327-334.
Niehoff AG, Haeften TW, Onland-Moret NL, et al. C-reactive protein is independently associated with glucose but not with insulin resistance in healthy men. Diabetes Care. 2007; 30: 1627-1629.
Nabipour I, Vahdat K, Jafari SM, et al. Elevated high sensitivity C-reactive protein is associated with type 2 diabetes mellitus: The Persian Gulf healthy heart study. Endocrine Journal. 2008; 55: 717-722.
Amoah AG, Schuster DP, Gaillard T, et al. Insulin Resistance, ß-cell function and cardiovascular risk factors in Ghanians with varying degree of glucose tolerance. Ethnicity& Disease. 2002; 12: 10-17.
WHO. Report of a WHO/IDF consultation: Definition, diagnosis and classification of diabetes mellitus and intermediate hyperglycemia. Geneva. 2006, 7-9. http://www.who,int/diabetes/. Accessed- November 18, 2010.
Holmen R, Hines G, Kenneday I, et al. A calculator for HOMA .Diabetologia. 2004; 47: suppl 1: A222. www.dtu.ox.ac.uk/homa. Accessed- December 10,2010.
WHO/IASO/IOTF. The Asia-Pacific perspective: Redefining obesity and its treatment. Health Communications Australia, Melbourne,2000.
Chan JCN, Malik V, Jia W, et al. Diabetes in Asia; Epidemiology, risk factors and pathophysiology. JAMA. 2009; 301: 2129-2140.
Tint-Swe-Latt, Phyu-Phyu-Aung, Ko-Ko-Zaw, et al. Adult prevalence of diabetes mellitus and its sociodemographic, behavioral and physiological risk factors in Yangon Division. Paper of Myanmar Health Research Congress, Department of Medical Research. 2004.
Efrat S. Prospects for treatment of type 2 diabetes by expansion of the beta-cell mass. Diabetes 2001; 50(Suppl 1):S189–S190.
Reasner CA. What causes microvascular and macrovascular complications in patients with type 2 diabetes? Curriculum in: Type 2 Diabetes Mellitus in Practice. Projects In Knowledge &Medpage Partners in Diabetes Education. 2010 [Accessed 17 March 2011]
Kjems LL, Volund A, Madsbad S. Quantification of beta-cell function during IVGTT in Type II and non-diabetic subjects: assessment of insulin secretion by mathematical methods. Diabetologia. 2001; 44: 1339–1348.
Kathryn CR, Nelson MS, Sidney CF, et al. C-reactive protein predicts the deterioration of glycemia in Chinese subjects with impaired glucose tolerance. Diabetes Care. 2003; 26: 2323-2328.
Henareh L, Jogestrandt T, Agewall S. Glucose intolerance is associated with C-reactive protein and intima-media anatomy of the common carotid artery in patients with coronary heart disease. Diabetic Medicine. 2005; 22: 1212-1217.
Ming-hui G, Jie H, An-kang L, et al.. High sensitive C-reactive protein, adiponectin, and urine albumin excretion rate in Chinese coronary artery disease patients with different glucose tolerance status. Chinese Medical Journal. 2008; 121: 2509-2516.
Ren J, Pang ZC, Gao WG, et al. C-reactive protein and gamma-glutamyltransferase concentrations in relation to the prevalence of type 2 diabetes diagnosed by glucose or HbA1c criteria in Chinese adults in Qingdao, China. Hindawi Publishing Corporation.Experimental Diabetes Research. Volume 2010; 10: 1155, 2010, 761715.
Snijder MB, Dekker JM, Visser JM, et al. Prospective relation of C-reactive protein with type 2 diabetes (Letter). Diabetes Care. 2003; 26: 1656–1657.
Ridker PM, Buring JE, Cook NR, et al. C reactive protein, metabolic syndrome and risk of incident cardiovascular events. Circulation. 2003; 107: 391-397.
Doi Y, Kiyohara Y, Kubo M, et al. Iida M. Elevated C-reactive protein is a predictor of the development of diabetes in a general Japanese population: The Hisayama study. Diabetes Care. 2005; 28: 2497–2500.
Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004; 27: 1487–1495.
Chailurkit L, Jongjaroenprasert W, Chanprasertyothin S, et al.. Insulin and C-Peptide Levels, Pancreatic Beta Cell Function, and Insulin Resistance Across Glucose Tolerance Status in Thais. Journal of Clinical Laboratory Analysis. 2007; 21: 85–90.
Fukushima M, Usami M, Ikeda M, et al. Insulin secretion and insulin sensitivity at different stages of glucose tolerance: A cross-sectional study of Japanese type 2 diabetes. Metabolism 2004;53:831–835.
Maki KC, McKenney JM, Farmer MV, et al. Indices of insulin sensitivity and secretion from a standard liquid meal test in subjects with type 2 diabetes, impaired or normal fasting glucose. Nutritional Journal. 2009; 8: 1-10.
Sung K, Reaven GM, Kim SH. Utility of homeostasis model assessment of beta cell function in predicting diabetes in 12,924 healthy Koreans. Diabetes Care. 2010; 33: 200-202.
Bonora E, Targher G, Alberiche M, et al. Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care 2000; 23:57–63.
Jensen CC, Cnop M, Hull RL, et al. Beta-cell function is a major contributor to oral glucose tolerance in high risk relatives of four ethnic groups in the U.S. Diabetes. 2002; 51: 2170–2178.
Stancakova A, Javorsky M, Kuulasmaa T, et al. Changes in insulin sensitivity and insulin release in relation to glycemia and glucose tolerance in 6, 414 Finnish men. Diabetes. 2009; 58: 1212-1221.
Festa A, Williams K, Hanley AJ, et al. Beta-cell dysfunction in subjects with impaired glucose tolerance and early type 2 diabetes: Comparison of surrogate markers with first-phase insulin secretion from an intravenous glucose tolerance test. Diabetes. 2008; 57 (6): 1638–44.
Tripathy D, Carlsson M, Almgren P, et al. Insulin secretion and insulin sensitivity in relation to glucose tolerance. Diabetes. 2000; 49: 975-980.
Yeni-Komshian H, Carantoni M, Abbasi F, et al. Relationship between several surrogate estimates of insulin resistance and quantification of insulin-mediated glucose disposal in 490 healthy nondiabetic volunteers. Diabetes Care. 2000; 23: 171-175.
Snehalatha C, Satyavani K, Sivasankari S, et al. Insulin secretion and action in different stages of glucose tolerance in Asian Indians. Diabet Met. 1998; 16(5): 408-14.
Ali A, Azim W. Insulin resistance and insulin secretion at varying levels of glucose. Pakistan Armed Force Medical Journal. ISSN 0030-9648.2010; 2.
Ning F, Qiao Q, Tuomilehto J, et al. Does abnormal insulin action or insulin secretion explain the increase in prevalence of impaired glucose metabolism with age in populations of different ethnicities? Diabetes Metab Res Rev. 2010; 26: 245-253.
Marx N, Walcher D, Raichle C, et al. C-peptide colocalizes with macrophages in early arteriosclerotic lesions of diabetes subjects and induces monocyte chemotaxis in vitro. ArteriosclerThrombVasc Biol. 2004; 24: 540-545.
Ford ES. Body mass index, diabetes and C reactive protein among US adults.Diabetes Care. 1999; 22: 1971-1977.
Festa A, D’ Agostino RJ, Tracy RP, et al. Elevated levels of acute phase protein and plasminogen activator inhibitor-1 predicts the development of type 2 diabetes. Diabetes. 2002; 51: 1131-1137.
Vikram NK, Misra A, Dwivedi M, et al. Correlation of CRP levels with anthropometric profile,percentage of body fat and lipids in healthy adolescents and young adults in urban North India. Atherosclerosis. 2003; 168: 305-313.
Wopereis S, Rubingh CM, Erk MJV, et al. Metabolic profiling of the response to an oral glucose tolerance test detects subtle metabolic changes. PloS ONE. 2009; 4: 1-13.
Published
How to Cite
Issue
Section
License
Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).
To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to jafes@asia.com or jafes.editor@gmail.com.
A written agreement shall be emailed to the requester should permission be granted.
