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Factors associated with regression from prediabetes to normal glucose tolerance in a Korean general population: A community‐based 10‐year prospective cohort study
Author(s) -
Hwang YC.,
Cho IJ.,
Jeong IK.,
Ahn K. J.,
Chung H. Y.
Publication year - 2018
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13789
Subject(s) - prediabetes , medicine , endocrinology , body mass index , glucose tolerance test , prospective cohort study , bioelectrical impedance analysis , impaired glucose tolerance , insulin , population , insulin resistance , cohort , diabetes mellitus , type 2 diabetes , environmental health
Aim A proportion of people with prediabetes convert back to normal glucose tolerance. We sought to determine the clinical variables associated with conversion from prediabetes to normal glucose tolerance, with a focus on insulin secretory capacity, insulin sensitivity and body composition. Methods We followed 1731 people with prediabetes at baseline from the Korean Genome and Epidemiology Study every 2 years for 10 years. Oral glucose tolerance tests ( OGTT ) were performed, and muscle and fat mass were estimated using bioelectrical impedance analysis. Results During 10 years of follow‐up, 36% (623/1731) of people with prediabetes converted to normal glucose tolerance. Higher baseline fasting glucose, 2‐h OGTT glucose and triglyceride levels were inversely associated with this conversion. Higher 60‐min insulinogenic index ( IGI 60 ) at baseline was independently associated with this conversion [ HR per sd (95% CI ) 1.09 (1.02–1.17); P = 0.01]. However, other indices reflecting insulin sensitivity, including the composite insulin sensitivity index, were not associated with this conversion. In addition, a higher baseline muscle to fat ratio was independently associated with conversion to normal glucose tolerance [ HR per sd (95% CI ) 1.15 (1.04–1.26); P = 0.005]. People with conversion to normal glucose tolerance showed a greater increase in the 60‐min insulinogenic index and disposition index and a smaller decrease in the composite insulin sensitivity index compared with people without conversion during 10 years of follow‐up (all p‐values < 0.001). Conclusion A higher insulin secretory capacity at baseline and during follow‐up and higher baseline muscle to fat ratio were independently associated with an improvement in glucose tolerance in Korean adults with prediabetes.