Diabetes Metab J.  2011 Apr;35(2):138-148. 10.4093/dmj.2011.35.2.138.

The Association of Unintentional Changes in Weight, Body Composition, and Homeostasis Model Assessment Index with Glycemic Progression in Non-Diabetic Healthy Subjects

• Rhee EJ
• Choi JH
• Yoo SH
• Bae JC
• Kim WJ
• Choi ES
• Park SE
• Park CY
• Park SW
• Oh KW
• Park SW
• Kim SW
• Lee WY

• KMID: 2281712
• DOI: http://doi.org/10.4093/dmj.2011.35.2.138

Abstract

BACKGROUND
We performed a retrospective longitudinal study on the effects of changes in weight, body composition, and homeostasis model assessment (HOMA) indices on glycemic progression in subjects without diabetes during a four-year follow-up period in a community cohort without intentional intervention.
METHODS
From 28,440 non-diabetic subjects who participated in a medical check-up program in 2004, data on anthropometric and metabolic parameters were obtained after four years in 2008. Body composition analyses were performed with a bioelectrical impedance analyzer. Skeletal muscle index (SMI, %) was calculated with lean mass/weightx100. Subjects were divided into three groups according to weight change status in four years: weight loss (< or =-5.0%), stable weight (-5.0 to 5.0%), weight gain (> or =5.0%). Progressors were defined as the subjects who progressed to impaired fasting glucose or diabetes.
RESULTS
Progressors showed worse baseline metabolic profiles compared with non-progressors. In logistic regression analyses, the increase in changes of HOMA-insulin resistance (HOMA-IR) in four years presented higher odds ratios for glycemic progression compared with other changes during that period. Among the components of body composition, a change in waist-hip ratio was the strongest predictor, and SMI change in four years was a significant negative predictor for glycemic progression. Changes in HOMA beta-cell function in four years was a negative predictor for glycemic progression.
CONCLUSION
Increased interval changes in HOMA-IR, weight gain and waist-hip ratio was associated with glycemic progression during a four-year period without intentional intervention in non-diabetic Korean subjects.

Keyword

Glycemic progression; Prediabetes; Skeletal muscle index; Visceral obesity; Weight change

MeSH Terms

Body Composition
Body Weight
Cohort Studies
Electric Impedance
Fasting
Follow-Up Studies
Glucose
Homeostasis
Logistic Models
Longitudinal Studies
Metabolome
Muscle, Skeletal
Obesity, Abdominal
Odds Ratio
Prediabetic State
Retrospective Studies
Waist-Hip Ratio
Weight Gain
Weight Loss
Glucose

Figure

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  Fig. 1 Selection of study participants.

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  Fig. 2 The proportion of the subjects who progressed according to the three groups of (A) weight change status, tertiles groups of (B) percent body fat, (C) skeletal muscle indexa, (D) waist-hip ratio, (E) homeostasis model assessment-insulin resistance (HOMA-IR), (F) HOMA β-cell during 4 years of follow-upb. aSkeletal muscle index derived from the formula: lean mass/weight (kg)×100 (%), bP<0.01 in comparisons analyses of the proportions between the groups in all components with Pearson's chi-square test.

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