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Erschienen in:
01.01.2003 | Article
Proinsulin and acute insulin response independently predict Type 2 diabetes mellitus in men—report from 27 years of follow-up study
Erschienen in: Diabetologia | Ausgabe 1/2003
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Aims/hypothesis
Defects in insulin secretion and insulin action, resulting in compensatory hyperinsulinaemia, are the major abnormalities in the development of Type 2 diabetes mellitus (Type 2 diabetes). The most frequently used conventional immunoreactive assays for insulin cross-react with proinsulin. In short-term studies (<5 years), proinsulin predicts the development of Type 2 diabetes. We studied, with a 27-year follow-up, the longitudinal relationships between intact proinsulin, 32–33 split proinsulin, specific and immunoreactive insulin (IRI), acute insulin response (AIR) after an intravenous glucose load and the development of Type 2 diabetes in a population-based cohort of 50-year-old men.
Methods
Fasting peptide concentrations were measured in plasma samples, stored since 1970–73 using specific two-site immunometric assays. IRI was measured at baseline using radioimmunoassay. Associations between development of Type 2 diabetes and predictor variables, were analysed with logistic regression. Results are shown as odds ratios (ORs) with their 95% confidence intervals (CIs) for a one standard deviation increase in a predictor variable.
Results
Cumulative incidence of Type 2 diabetes was 33% over 27 years of follow-up. Intact proinsulin (OR, 1.57, CI, 1.16–2.14), and 32–33 split proinsulin (OR, 1.70, CI, 1.20–2.39) were associated with development of Type 2 diabetes, independent of AIR, adjusted for BMI and fasting glucose, whereas specific insulin was not (OR, 1.31, CI, 0.98–1.77), nor was IRI (OR, 1.25, CI, 0.96–1.63). Proinsulin and AIR interacted in the development of Type 2 diabetes (p<0.05).
Conclusion/interpretation
Proinsulin predicts the development of Type 2 diabetes mellitus over a 27-year period.