Basal-State Hyperinsulinemia in Healthy Normoglycemic Adults Is Predictive of Type 2 Diabetes Over a 24-Year Follow-Up
A preliminary report
- Rachel Dankner, MD, MPH1,2,
- Angela Chetrit, MA1,
- Michael H. Shanik, MD3,4,
- Itamar Raz, MD5 and
- Jesse Roth, MD6,7
- 1Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Israel,
- 2Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
- 3Island Endocrinology, Smithtown, New York;
- 4Department of Internal Medicine, Stony Brook University Hospital, Stony Brook, New York;
- 5Diabetes Unit, Department of Internal Medicine, Hadassah University Hospital, Jerusalem, Israel;
- 6Feinstein Institute for Medical Research, North Shore-Long Island Jewish Health System, Manhasset, New York;
- 7Albert Einstein College of Medicine, Yeshiva University, Bronx, New York.
- Corresponding author: Rachel Dankner, racheld{at}gertner.health.gov.il.
Abstract
OBJECTIVE We examined the predictive value of hyperinsulinemia in the basal state on the 24-year progression from normoglycemia to dysglycemia.
RESEARCH DESIGN AND METHODS A sample of 515 normoglycemic men and women were studied again after 24 years for glycemic status.
RESULTS Half of the participants developed dysglycemia: 11.1% progressed to impaired fasting glucose (IFG), 9.9% to impaired glucose tolerance (IGT), 4.5% to both IFG and IGT, and another 24.3% to type 2 diabetes. Elevated levels of overnight fasting (basal) insulin, triglycerides, BMI ≥27 kg/m2, fasting blood glucose, blood pressure, North African or Yemenite background, and male sex each favored conversion to dysglycemia after 24 years. In multiple ordered logistic regression analysis, the most significant predictor of progression to dysglycemia was hyperinsulinemia (upper quintile), after adjusting for BMI, ethnic origin, sex, age, smoking, physical activity, blood pressure, and triglycerides.
CONCLUSIONS Basal hyperinsulinemia in normoglycemic adults constitutes an independent risk factor for developing dysglycemia over 24 years.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received January 26, 2009.
- Accepted May 3, 2009.
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Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
- © 2009 by the American Diabetes Association.
