Korean Diabetes J.  2008 Dec;32(6):498-505. 10.4093/kdj.2008.32.6.498.

Insulin Sensitivity and Insulin Secretion Determined by Homeostasis Model Assessment and Future Risk of Diabetes Mellitus in Korean Men

• Choi ES
• Rhee EJ
• Kim JH
• Won JC
• Park CY
• Lee WY
• Oh KW
• Park SW
• Kim SW

• KMID: 2222457
• DOI: http://doi.org/10.4093/kdj.2008.32.6.498

Abstract

BACKGROUND
Insulin resistance and progressive pancreatic beta cell dysfunction have been identified as the two fundamental features in the type 2 diabetes. Homeostasis model assessment (HOMA), based on plasma levels of fasting glucose and insulin, has been widely validated and applied for quantifying insulin resistance and secretion. This study was performed to assess the predictive value of HOMA indices for future diabetes risk.
METHODS
In 14,976 Korean men, in which medical check-up was performed both in 2002 and 2006 in a university hospital health promotion center in Seoul, Korea, prospective assessment for diabetes risk was assessed. At baseline, anthropometric measurements were done and fasting glucose, insulin, lipid profiles were measured. HOMA-insulin resistance (HOMA-IR) and beta cell function (HOMA beta-cell) were calculated from fasting glucose and insulin levels.
RESULTS
After 4 years, 286 subjects (1.9%) were newly diagnosed as diabetes mellitus. These patients (mean age 40.3 years) were age-matched with 632 control subjects (mean age 39.8 years) and diabetes risk was assessed with HOMA indices. Among the parameters, body mass index, fasting glucose and HOMA beta-cell were the significant determinants for future diabetes risk. When the subjects were divided into two groups according to the baseline median values of HOMA-IR and HOMA beta-cell, and assessed jointly, those with the low HOMA beta-cell and high HOMA-IR showed the highest risk for future diabetes (RR 39.065, 95% CI 11.736~130.035, P < 0.01). The subjects with low baseline HOMA beta-cell showed higher RR for diabetes than those with high baseline HOMA-IR (4.413 vs. 3.379, P = 0.018, P = 0.051).
CONCLUSION
High HOMA-IR and low HOMA beta-cell were associated with the highest risk for future diabetes in this prospective study of Korean male subjects. These data suggest the value of HOMA indices for diabetes risk in epidemiologic studies in Asian subjects.

Keyword

Diabetes mellitus; HOMA-IR; HOMA beta-cell

MeSH Terms

Asian Continental Ancestry Group
Body Mass Index
Diabetes Mellitus
Fasting
Glucose
Health Promotion
Homeostasis
Humans
Insulin
Insulin Resistance
Insulin-Secreting Cells
Korea
Male
Plasma
Prospective Studies
Glucose
Insulin

Figure

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  Fig. 1 Selection and entry of study subjects in this study.

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