Abstract
Aims
To assess the impact of metabolic syndrome (MetS) on the incidence of type 2 diabetes in middle-aged Japanese individuals with impaired insulin secretion (IIS).
Methods
This cohort study included 1,702 individuals aged 40–59 without diabetes at baseline who underwent a comprehensive medical check-up between April 2008 and March 2009 at Saku Central Hospital. Participants were classified according to their IIS and insulin resistance (IR) status [normal, isolated IR (i-IR), or isolated IIS (i-IIS)] and MetS (presence or absence). They were followed up until March 2014. Type 2 diabetes was defined based on fasting and 2-h post-load plasma glucose concentrations and by the receipt of medical treatment for diabetes.
Results
During 7,572 person-years of follow-up, 92 individuals developed type 2 diabetes. The incidence rates (/1,000 person-years) for type 2 diabetes in the normal without MetS, normal with MetS, i-IR without MetS, i-IR with MetS, i-IIS without MetS, and i-IIS with MetS groups were 5.3, 3.7, 11.3, 24.7, 16.7, and 59.5, respectively. The multivariable-adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) for type 2 diabetes in the normal with MetS, i-IR with MetS, and i-IIS with MetS groups, relative to the normal without MetS group, were 0.52 (0.12–2.25), 3.78 (1.93–7.42), and 7.94 (3.96–15.91), respectively. Additionally, a positive association of MetS with type 2 diabetes was observed in the i-IIS group [HR (95 % CI) 3.56 (1.88–6.73)] but not in the normal and i-IR groups.
Conclusions
The prevention of MetS is important, particularly in individuals with low insulin secretion.
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Acknowledgments
The authors sincerely thank Dr. K. Deura (Saku Central Hospital, Saku, Japan), Ms. F. Soyano (Saku University, Saku, Japan), and Ms. F. Sato (Saku Central Hospital, Saku, Japan) for their contributions to the Saku study. This work was supported by a Japan Society for the Promotion of Science (JSPS) Grant-in-Aid for Research Activity Start-up (Grant No. 25882019) and a JSPS Grant-in-Aid for Young Scientists (B) (Grant No. 15K16513).
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revisions. Informed consent or a substitute for it was obtained from all participants before they were included in the study.
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Morimoto, A., Tatsumi, Y., Sonoda, N. et al. Impact of metabolic syndrome on the incidence of type 2 diabetes in middle-aged Japanese individuals with impaired insulin secretion: the Saku study. Diabetol Int 8, 104–111 (2017). https://doi.org/10.1007/s13340-016-0287-6
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DOI: https://doi.org/10.1007/s13340-016-0287-6