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KMID : 1200020110350020138
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Diabetes & Metabolism Journal
2011 Volume.35 No. 2 p.138 ~ p.148
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The Association of Unintentional Changes in Weight, Body Composition, and Homeostasis Model Assessment Index with Glycemic Progression in Non-Diabetic Healthy Subjects
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Rhee Eun-Jung
Choi Ji-Hun
Yoo Seung-Hyun
Bae Ji-Cheol
Kim Won-Jun
Choi Eun-Suk
Park Se-Eun
Park Cheol-Young
Park Seok-Won
Oh Ki-Won
Park Sung-Woo
Kim Sun-Woo
Lee Won-Young
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Abstract
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Background: We performed a retrospective longitudinal study on the effects of changes in weight, body composition, and homeostasis model assessment (HOMA) indices on glycemic progression in subjects without diabetes during a four-year follow-up period in a community cohort without intentional intervention.
Methods: From 28,440 non-diabetic subjects who participated in a medical check-up program in 2004, data on anthropometric and metabolic parameters were obtained after four years in 2008. Body composition analyses were performed with a bioelectrical impedance analyzer. Skeletal muscle index (SMI, %) was calculated with lean mass/weight×100. Subjects were divided into three groups according to weight change status in four years: weight loss (≤-5.0%), stable weight (-5.0 to 5.0%), weight gain (≥5.0%). Progressors were defined as the subjects who progressed to impaired fasting glucose or diabetes.
Results: Progressors showed worse baseline metabolic profiles compared with non-progressors. In logistic regression analyses, the increase in changes of HOMA-insulin resistance (HOMA-IR) in four years presented higher odds ratios for glycemic progression compared with other changes during that period. Among the components of body composition, a change in waist-hip ratio was the strongest predictor, and SMI change in four years was a significant negative predictor for glycemic progression. Changes in HOMA β-cell function in four years was a negative predictor for glycemic progression.
Conclusion: Increased interval changes in HOMA-IR, weight gain and waist-hip ratio was associated with glycemic progression during a four-year period without intentional intervention in non-diabetic Korean subjects.
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KEYWORD
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Glycemic progression, Prediabetes, Skeletal muscle index, Visceral obesity, Weight change
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