Horm Metab Res 2005; 37(10): 622-626
DOI: 10.1055/s-2005-870537
Original Clinical
© Georg Thieme Verlag KG Stuttgart · New York

New “Pre-diabetes” Category and the Metabolic Syndrome in Japanese

M.  Kanauchi1 , T.  Kawano1 , K.  Kanauchi2 , Y.  Saito1
  • 1First Department of Internal Medicine, Nara Medical University
  • 2Health Care Unit, SHARP Corporation, Japan
Further Information

Publication History

Received 4 October 2004

Accepted after revision 5 April 2005

Publication Date:
08 November 2005 (online)

Abstract

Background: Recently, impaired fasting glucose (IFG) was redefined as fasting plasma glucose of 100 - 125 mg/dl, and individuals with IFG and/or impaired glucose tolerance (IGT) were referred to as having “pre-diabetes”. However, there is a lack of data using the new definition of IFG and “pre-diabetes”. Objective: The aim of this study was to examine associations of the metabolic syndrome components with the new “pre-diabetes” category in relatively lean Japanese. Methods: Six hundred and sixty-one Japanese study participants underwent a 75 g oral glucose tolerance test. They were classified into three groups-normal (n = 225), pre-diabetes (n = 308), and diabetes (n = 128). The metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III, as modified for waist circumference criteria by the Regional Office for the Western Pacific Region of WHO. Results: Prevalence of the metabolic syndrome in each group was 10.7 %, 27.9 %, and 53.9 %, respectively. Of the metabolic syndrome components, the OR for prevalent pre-diabetes was 2.00 (95 % CI, 1.73 - 2.31, p < 0.001) for fasting glucose, 1.93 (95 % CI, 1.54 - 2.42, p < 0.001) for waist circumference, and 1.36 (95 % CI, 1.10 - 1.68, p = 0.005) for triglycerides. Similar associations were found in prevalent diabetes. Insulin resistance assessed using Stumvoll’s index was significantly associated with both pre-diabetes and diabetes. Conclusion: Pre-diabetes and the metabolic syndrome frequently coexist in relatively lean Japanese. This association seems to link with abdominal adiposity and insulin resistance.

References

  • 1 The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus . Follow-up report on the diagnosis of diabetes mellitus.  Diabetes Care. 2003;  26 3160-3167
  • 2 American Diabetes Association . Diagnosis and classification of diabetes mellitus.  Diabetes Care. 2004;  27 (Suppl. 1) S5-S10
  • 3 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults . Executive Summary of the Third Report of the National Cholesterol Education Program.  JAMA. 2001;  285 2486-2497
  • 4 Steering Committee of the Western Pacific Region of the World Health Organization, the International Association for the Study of Obesity, and the International Obesity Task Force .The Asia-Pacific perspective. Redefining Obesity and its Treatment. Health Communications Australia Pty Ltd 2000
  • 5 Friedwald W T, Levy R I, Fredrickson D S. Estimation of the concentration of low-density lipoprotein cholesterol in plasma without use of the preparative ultracentrifuge.  Clin Chem. 1972;  18 499-508
  • 6 Stumvoll M, Mitrakou A, Pimenta W, Jenssen T, Yki-Jarvinen H, Van Haeften T, Renn W, Gerich J. Use of oral glucose tolerance test to assess insulin release and insulin sensitivity.  Diabetes Care. 2000;  23 295-301
  • 7 Kanauchi M, Tsujimoto N, Hashimoto T. Validation of simple indices to assess insulin sensitivity based on the oral glucose tolerance test in the Japanese population.  Diabetes Res Clin Pract. 2002;  55 229-235
  • 8 Weyer C, Bogardus C, Pratley R E. Metabolic characteristics of individuals with impaired fasting glucose and/or impaired glucose tolerance.  Diabetes. 1999;  48 2197-2203
  • 9 Chiu K C, Cohan P, Lee N P, Chuang L-M. Insulin sensitivity differs among ethnic groups with a compensatory response in beta-cell function.  Diabetes Care. 2000;  23 1353-1358
  • 10 de Vegt F, Dekker J M, Jager A, Hienkens E, Kostense P J, Stehouwer C DA, Nijpels G, Bouter L M, Heine R J. Relation of impaired fasting and postload glucose with incident type 2 diabetes in a Dutch population.  JAMA. 2001;  285 2109-2113
  • 11 Haffner S M, Miettinen H, Gaskill S P, Stern M P. Decreased insulin secretion and increased insulin resistance are independently related to the 7-year risk of non-insulin dependent diabetes mellitus in Mexican Americans.  Diabetes. 1995;  44 1386-1391
  • 12 WHO Expert Consultation . Appropriate body mass index for Asian populations and its implications for policy and intervention strategies.  Lancet. 2004;  363 157-163
  • 13 Bloomgarden Z T. Definitions of the insulin resistance syndrome.  Diabetes Care. 2004;  27 824-830
  • 14 World Health Organization .Obesity.  WHO Technical Report Series 894. Geneva; WHO 2000
  • 15 Balkau B, Charles M A,. the European Group for the Study of Insulin Resistance (EGIR) . Comment on the provisional report from the WHO consultation.  Diabet Med. 1999;  16 442-443
  • 16 Ruderman N, Chisholm D, Pi-Sunyer X, Schneuder S. The metabolically obese, normal-weight individual revisited.  Diabetes. 1998;  47 699-713
  • 17 Matthews D R, Hosker J P, Rudenski A S, Naylor B A, Treacher D F, Turner R C. Homeostasis model assessment. Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in men.  Diabetologia. 1985;  28 412-419
  • 18 Gutt M, Davis C L, Spitzer S B, Llabre M M, Kumar M, Czarnecki E M, Schneiderman N, Skyler J S, Marks J B. Validation of the insulin sensitivity index comparison with other measures.  Diabetes Res Clin Pract. 2000;  47 177-184
  • 19 Matsuda M, DeFronzo R A. Insulin sensitivity indices obtained from oral glucose tolerance testing.  Diabetes Care. 1999;  22 1462-1470

Dr. Masao Kanauchi

First Department of Internal Medicine

Nara Medical University · 840 Shijo-cho · Kashihara · Nara 634-0813 · Japan

Phone: +81 (744) 22 30 51

Fax: +81 (744) 28 18 80 ·

Email: kanauchi@nmu-gw.naramed-u.ac.jp

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