Session: SUN 690-701-Obesity Pathophysiology
Poster Board SUN-698
Objectives: Based on both facts that BMI is associated with insulin resistance, and insulin secretory function negatively associates with GA/A1c ratio but not insulin resistance ((2),(3),(4),(5)), the objective of this study was to evaluated whether the negative correlation between GA/A1c ratio and BMI is due to compensatory insulin secretory function, which overshadows the contribution of insulin resistance or not.
Design and Methods: In a retrospective study, we analyzed 242 drug-naïve patients recently diagnosed with type 2 diabetes, 185 pre-diabetic patients, and 69 patients with normal glucose tolerance (NGT). To assess the effects of BMI, homeostasis model assessment-insulin resistance (HOMA-IR), and homeostasis model assessment- pancreatic beta-cell function (HOMA-β) on GA/A1c ratio, a statistical analysis was performed using multivariate regression analysis. And to evaluate the direct and indirect effects of insulin secretory function and BMI on GA/A1c ratio, we employed structural equation models (SEM)((6)).
Results: The negative association between GA/A1c ratio and BMI were most prominent in the NGT group. (NGT: R = –0.594, P < 0.001; prediabetes: R = –0.227, P < 0.01; and type 2 diabetes: R = –0.224, P< 0.001). And in SEM analysis, the estimates of total effect of BMI on GA/A1c ratio were –0.621 (P < 0.001) , –0.251 (P = 0.053) , and –0.235 (P = 0.08) in the NGT, pre-diabetes, and type 2 diabetes groups, respectively. This result might be explained because in NGT group, compensatory insulin secretory fuction is preserved, so, the more BMI is higher, the more HOMA-β is higher, and therefore GA/A1c ratio is more prominent lower because of the negative association between HOMA-β an GA/A1c ratio. But, in prediabetes and diabetes group, relatively impaired compensatory insulin secretory fuction group, in spite of higher BMI, HOMA-β can not be fully increased, so, the degree of decrease in GA/A1c is lower than other group.
Conclusions: Degrees of negative influence of BMI on the ratio of GA/A1c ratio might be dependent on compensatory secretory function over insulin resistance and these effects are different between NGT and diabetes group.
Nothing to Disclose: JHH, BWL
*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm
See more of: Abstracts - Orals, Featured Poster Presentations, and Posters