Risk Factors for the Development of NIDDM in Yonchon County, Korea
- Chan Soo Shin, MD,
- Hong Kyu Lee, MD,
- Chang-Soon Koh, MD,
- Yong Ik Kim, MD,
- Young Soo Shin, MD,
- Keun Young Yoo, MD,
- Hee Young Paik, PHD,
- Yong Soo Park, MD and
- Byung Goog Yang, MD
- Departments of Internal Medicine, Seoul National University Kyunggi-Do, Korea
- Departments of Health Policy and Management, Seoul National University Kyunggi-Do, Korea
- Departments of Preventive Medicine, Seoul National University Kyunggi-Do, Korea
- Departments of Food and Nutrition, Seoul National University Kyunggi-Do, Korea
- Department of Internal Medicine, Hanyang University College of Medicine Seoul
- Yonchon Health Center Kyunggi-Do, Korea
- Address correspondence and reprint requests to Hong Kyu Lee, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul 110–744, Korea. E-mail: hkleemd{at}plaza.snu.ac.kr
Abstract
OBJECTIVE To determine the risk factors for the development of NIDDM in Yonchon County of Korea.
RESEARCH DESIGN AND METHODS We studied 1,193 Korean nondiabetic subjects at baseline who participated in a 2-year follow-up study on diabetes in Yonchon County. A 75-g oral glucose tolerance test was performed 2 years after the baseline examination. Age, sex, and anthropometric and metabolic characteristics at baseline were analyzed simultaneously as potential predictors of conversion to NIDDM. We also designed a nested case-control study to determine the role of hyperinsulinemia and/or hyperproinsulinemia in the conversion to NIDDM in patients with newly developed diabetes and control subjects matched for age, sex, BMI, and waist-to-hip-ratio.
RESULTS At 2 years, 67 subjects developed diabetes, as defined by World Health Organization criteria. The age-adjusted incidence was significantly higher in men (6.4%) than in women (3.0%), and the incidence increased as age increased in both sexes. Multiple logistic regression analysis revealed age, male sex, and fasting and 2-h glucose levels to be significant risk factors for the development of NIDDM, whereas waist-to-hip ratio and BMI were not. In a nested case-control study, baseline proinsulin but not insulin levels were significantly higher in subjects who progressed to NIDDM than in those who did not.
CONCLUSIONS In the Korean population, β-cell dysfunction, as measured by high proinsulin levels, seems to be associated with subsequent development of NIDDM, whereas regional and general obesity and fasting insulin levels, which may be a surrogate for insulin resistance, were not.
- Received April 5, 1997.
- Revision received August 6, 1997.
- Accepted August 6, 1997.
- Copyright © 1997 by the American Diabetes Association
