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Since there had been no previous studies of alterations in insulin sensitivity, glucose-stimulated insulin secretion, beta cell function and glucose effectiveness during the development of non-diabetic hyperglycemia in Asian populations, we conducted a longitudinal study of such changes in 244 Japanese adults with normal glucose tolerance (median BMI 23.3 kg/m 2  and age 51 yrs). The median follow-up period was 3.3 yrs. One hundred and eighty-two subjects maintained normal glucose tolerance (nonprogressors). After excluding the 3 subjects who progressed to diabetes, we analyzed the 59 who developed non-diabetic hyperglycemia (progressors), of which 31 progressed to impaired fasting glucose and 28 to impaired glucose tolerance. Whole body insulin sensitivity was estimated by ISI Matsuda , glucose-stimulated insulin secretion by [δIRI 0-30 /δPG 0-30 ] and Stumvoll indices, hepatic insulin sensitivity by quantitative insulin sensitivity check index (QUICKI) and 1/fasting IRI, beta cell function by oral disposition index (DI O ) ([δIRI 0-30 /δPG 0-30 ]∙[ISI Matsuda ]), and glucose effectiveness by an OGTT-derived index (SgI O ). ISI Matsuda  ( p  <0.05), [δIRI 0-30 /δPG 0-30 ], DI O  and SgI O  (both  p  <0.01), but not QUICKI, 1/fasting IRI, or Stumvoll-1st and -2nd phases, were lower in the progressors at baseline. This group was also characterized by the following: 1) ISI Matsuda , DI O  and SgI O  were reduced by 34%, 32% and 11%, respectively (all  p  <0.01); 2) QUICKI and 1/fasting IRI diminished by 21% and 5%, respectively (both  p  <0.01); and 3) no significant changes were found in [δIRI 0-30 /δPG 0-30 ], Stumvoll-1st and -2nd phases or BMI during the follow-up. In the nonprogressors, no indices changed significantly during the follow-up. Our study concluded that during the transition from normal glucose tolerance to non-diabetic hyperglycemia in this non-obese population, whole body insulin sensitivity, hepatic insulin sensitivity, beta cell function, and glucose effectiveness were all attenuated, but no significant changes in glucose-stimulated insulin secretion occurred. Also of note is the fact that the transition took place without any accompanying increase in BMI.   Electronic supplementary material  The online version of this article (doi:10.1186/2193-1801-3-252) contains supplementary material, which is available to authorized users.

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Longitudinal changes in insulin sensitivity, insulin secretion, beta cell function and glucose effectiveness during development of non-diabetic hyperglycemia in a Japanese population