[Glucose effectiveness and components of the metabolic syndrome in recently diagnosed hypertensive patients]

The relationships between hemoglobin and insulin resistance, glucose effectiveness, and first- and second-phase insulin secretion in adult Chinese

OBJECTIVE

We denote the four major factors related to the development of type 2 diabetes (T2D) as "diabetes factor" (DF); increased insulin resistance (IR); decreased glucose effectiveness (GE); and the first-and-second-phase of insulin secretion (FPIS, SPIS). The level of hemoglobin (Hb) was found to be related to IR and FPIS, but no-known studies focused on its role in relation to SPIS and GE. In this study, we aim to evaluate the relationships between Hb and all four DFs in the same individual.

SUBJECTS AND METHODS

We randomly enrolled 24,407 men and 24,889 women between 30 and 59 years old. IR, FPIS, SPIS and GE were measured according to equations published in our previous studies. To compare the slopes between Hb and the four DFs with different units, we converted their units to percent of change per unit of increased Hb.

RESULTS

Age, HDL-cholesterol and GE were higher in women; BMI, blood pressure, LDL-cholesterol, TG, Hb, FPIS, SPIS and IR were higher in men. After they were converted into percentage, the closeness of their relationships to Hb, from the highest to the lowest, were GE, IR, FPIS and SPIS for women and IR, GE, FPIS and SPIS for men. GE was the only one negatively related to Hb.

CONCLUSIONS

Our data showed that IR, FPIS and SPIS were both positively and, GE negatively, related to the Hb in adult Chinese. For women, GE had the closest association with Hb; for men, it was IR. Both phases of insulin secretion had relatively weaker relationships than IR and GE.

Predicting Glucose Effectiveness in Chinese Participants Using Routine Measurements

BACKGROUND

Glucose effectiveness (GE) is the capacity of glucose to increase its own uptake and to maintain endogenous hepatic glucose output under basal insulin levels. In addition to decreased insulin sensitivity (IS) and impaired insulin secretion, GE plays a critical role in glucose balance in patients with type 2 diabetes (T2DM). In the study, we developed an equation for predicting GE.

METHODS

We enrolled 227 participants with glucose tolerances ranging from normal glucose tolerance to diabetes. Of the participants, 75% (171) participants were randomly assigned to the study group, whose data were used to construct the equation for estimating GE. The remaining 56 participants comprised the validation group. All participants underwent a frequently sampled intravenous glucose tolerance test; IS, GE, and the acute insulin response after the glucose load were determined.

RESULTS

Age, triglyceride (TG), and fasting plasma glucose (FPG) were independently correlated with GE and selected for inclusion in multiple linear regression analysis. We constructed the following equation: GE = (29.196 - 0.103 × age - 2.722 × TG - 0.592 × FPG) × 10^-3. Using this same equation, we also calculated the GE of the validation group. The calculated GE was significantly correlated with the measured GE (r = 0.430, P = 0.001).

CONCLUSIONS

Using the equation based on routine measurements enabled the GE to be predicted with acceptable accuracy (r = 0.430). This method of predicting GE may aid clinicians in further understanding the underlying pathological mechanisms of T2DM.