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<p><b>OBJECTIVE</b>Since the incidence rates and risk factor for type 2 diabetes in Chinese populations had not been well known, the aim of this study was to evaluate the impact of weight change and other risk factors on incident type 2 diabetes in Qingdao, China.</p><p><b>METHODS</b>A prospective population-based cohort study was carried out, based on subjects aged 35-74 years who participated in the 'Qingdao Diabetes Survey' in 2006. Subjects were free of diabetes at baseline. A total of 1 294 subjects attended the follow up survey between 2009 and 2011. The diagnostic criteria for Diabetes was classified according to both the World Health Organization and the International Diabetes Federation 2006. A logistic regression was built using the backward stepwise selection to assess the effects of risk factors on the incident type 2 diabetes.</p><p><b>RESULTS</b>During a 4-year follow up period, 120 cases with incident type 2 diabetes were identified, with cumulative incidence of diabetes as 11.8% . Participants who developed type 2 diabetes were significantly older, having significantly higher age-adjusted BMI/waist circumference/systolic blood pressure and total cholesterol, than those subjects who remained non-diabetic both in urban and rural areas. Among individuals with no diabetes at the baseline, factors as age, living in the rural areas, baseline BMI and weight change had all independently contributed to the development of diabetes. The multivariate adjusted relative risks (95%CIs) related to the incidence of diabetes were 1.45 (1.13-1.87), 1.93 (1.12-3.34), 1.46 (1.05-2.03) and 1.49 (1.18-1.88), respectively, for a one standard deviation increase in continuous variables. Compared with the reference group of non-obese and with stable weight, factor as weight loss >5% and BMI <28 kg/m² were independently associated with a 67% (RR = 0.33, 95% CI: 0.11-0.97)reduction in the risk of type 2 diabetes, while BMI >28 kg/m² could increase the risk across the levels of weight change. Similar trends were observed in higher waist and weight gain at baseline.</p><p><b>CONCLUSION</b>This study confirmed the critical importance of obesity in the development of type 2 diabetes. Baseline BMI and weight gain appeared independent predictors on type 2 diabetes.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Body Mass Index , Body Weight , China , Epidemiology , Diabetes Mellitus, Type 2 , Epidemiology , Follow-Up Studies , Incidence , Logistic Models , Prospective Studies , Risk Factors , Weight GainABSTRACT
Objective To investigate the effects of basal and early phase insulin secretion on plasma glucose level in type 2 diabetes. Methods Plasma glucose and true insulin levels were measured at 0, 30, 60, 120 min during standard meal test in 81 patients with type 2 diabetes. Insulin sensitivity index (ISI) and insulin secretion index (?I 30 /?G 30 ) were calculated for evaluating the insulin sensitivity. Contributions of basal and early insulin secretion to plasma glucose level were evaluated by multivariate regression analysis with SAS software. Results ISI and ?I 30 /?G 30 showed nearly equal effects on plasma glucose levels by multivariate regression analysis. Among insulin levels of different time points during standard meal test, basal and postprandial 60 min insulin levels played important roles in changes of plasma glucose levels. The effect of fasting insulin on the area under plasma glucose curve was stronger than that of ?I 30 /?G 30 . Conclusion Both basal and early insulin secretions greatly contribute to glycemic control.
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Objective To compare the demographic and anthropometric characteristics of IFH,IPH and CH in a Chinese newly diagnosed diabetes population and to evaluate the metabolic profiles of insulin secretion and insulin sensitivity associated with subcategories of newly diagnosed type 2 diabetes.Methods From Mar.2005 to June 2002,in Qingdao 335 patients with newly diagnosed diabetes were classified into three groups:IFH(n=67),IPH(n=92),and CH(n=176).Meanwhile,411(191males)subjects with age-sex matched were selected as control group. Homeostasis model assessment(HOMA-IR)and LIGUANGWEI index(IAI)were applied to assess the status of insulin resistance.Homeostasis model assessment(HOMA-B)and I_0/G_0 were applied to assess the basic function of islet B cell,and I_ 120 /G_ 120 was applied to assess the postload function of islet B cell. Results HOMA-IR increased and IAI decreased significantly in CH group than in IFH and IPH group(P
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0.05),and the distribution of genotypes was in Hardy-Weinberg equilibrium.Data analysis showed Met326Ile variant did not impact on FIns,FPG,HOMA index,BMI and gene expression of PI3-K,though the expression of PI3-K gene was lower in type 2 diabetes than in control group.Conclusion The Met326Ile variant of the p85? regulatory subunit of PI3-K is likely to be functionally normal in type 2 diabetes and health people.
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The relation of metabolic syndrome and its components with body mass index (BMI) was investigated in Zhanshan community, Qingdao. The results showed that the prevalence and relative risk of metabolic syndrome and its components were increased with BMI. Nearly one-third of individuals with overweight or obesity had metabolic syndrome.