Differences in insulin action and secretion, plasma lipids and blood pressure levels between impaired fasting glucose and impaired glucose tolerance in Japanese subjects

Yoshinori Miyazaki, Hiroshi Akasaka, Hirofumi Ohnishi, Shigeyuki Saitoh, Ralph A. DeFronzo, Kazuaki Shimamoto

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

We examined insulin action/secretion and cardiovascular disease risk factors in Japanese subjects with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) who were not taking any medications known to affect glucose tolerance, blood pressure (BP) or plasma lipids (PLs). A total of 1,399 subjects received measurements of anthropometry, BP, PLs, and plasma glucose/insulin concentrations during 75 goral glucose tolerance test (OGTT). According to 2003 American Diabetes Association criteria, subjects were classified as having normal fasting glucose (NFG)/normal glucose tolerance (NGT) (n=1,173), IFG (n=128), IGT (n=55), and IFG/IGT (n=43). Insulin action was calculated using the HOMA-R (index of hepatic insulin resistance) and Matsuda index (reflects whole body insulin sensitivity). The ratio of the incremental area under the curve of insulin to that of glucose during OGTT (ΔAUCPI/ΔAUCPG) was used as an index of β-cell function. HOMA-R was higher in IFG (2.3±0.1) and IFG/IGT (2.5±0.2) than in NFG/NGT (1.8±0.03). The Matsuda index was lower in IFG (6.5±0.3), IGT (5.4±0.4) and IFG/IGT (5.1±0.5) than in NFG/NGT (9.6±0.2). ΔAUCPI/ΔAUCPG was lower in IGT (0.6±0.05) and IFG/IGT (0.5±0.05) than in IFG (1.4±0.12) or NFG/NGT (1.2±0.03). Mean BP was higher in IGT (100±1.7 mmHg) than in NFG/NGT (91±0.3) or IFG (95±1.1). The plasma triglyceride level was higher in IGT (155±14 mg/dL) and IGT/IFG (173±12) than in IFG (132±7) or NFG/NGT (122±2). In conclusion, 1) whole body insulin sensitivity is decreased in IFG and IGT, with a greater reduction in IGT, 2) hepatic insulin resistance and preserved β-cell function are characteristics of IFG, and 3) higher BP and triglyceride levels are observed in IGT. IGT is more closely associated with risk factors for cardiovascular disease than is IFG.

Original languageEnglish (US)
Pages (from-to)1357-1363
Number of pages7
JournalHypertension Research
Volume31
Issue number7
DOIs
StatePublished - 2008

Keywords

  • Cardiovascular disease risk factors
  • Impaired fasting glucose
  • Impaired glucose tolerance

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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