Background
Methods
Subjects
Blood sampling and OGTT
Classification of glucose tolerance status
Classification of glucose curve shapes
Calculation of variables
Statistical analysis
Results
Baseline characteristics according to glucose curve shapes
Variables | Monophasic group (n = 7909) | Multiphasic group (n = 1150) | P value | Biphasic group (n = 548) | Triphasic group (n = 602) | P value |
---|---|---|---|---|---|---|
Age (years) | 38.6 ± 13.6 | 35.4 ± 13.5 | < 0.001 | 35.1 ± 13.7 | 35.8 ± 13.2 | 0.391 |
Sex (male/female), n% | 2100 (26.6)/5809 (73.4) | 219 (19.0)/931 (81.0) | < 0.001 | 106 (19.3)/442 (80.7) | 113 (18.8)/489 (81.2) | 0.805 |
FBG (mmol/L) | 5.6 ± 13.5 | 5.2 ± 0.6 | < 0.001 | 5.2 ± 0.6 | 5.2 ± 0.6 | 0.189 |
30 min GLU (mmol/L) | 9.5 ± 2.0 | 8.3 ± 1.6 | < 0.001 | 8.4 ± 1.6 | 8.2 ± 1.6 | <0.001 |
2 h GLU (mmol/L) | 8.2 ± 3.2 | 6.3 ± 2.0 | < 0.001 | 5.4 ± 1.8 | 7.2 ± 1.9 | <0.001 |
FINS | 14.8 ± 8.7 | 13.5 ± 7.9 | < 0.001 | 13.2 ± 8.4 | 13.7 ± 7.5 | 0.328 |
30 min INS | 97.7 ± 59.6 | 123.5 ± 67.1 | < 0.001 | 105.6 ± 62.0 | 139.7 ± 67.5 | <0.001 |
2 h INS | 106.9 ± 66.9 | 76.8 ± 57.8 | < 0.001 | 54.7 ± 43.2 | 96.8 ± 62.0 | <0.001 |
Glycemic status(%) | ||||||
NGT | 4253 (53.8) | 903 (78.5) | 486 (88.7) | 417 (69.3) | ||
IFG/IGT/IFG + IGT | 2362 (29.9) | 206 (17.9) | < 0.001 | 50 (9.1) | 156 (25.9) | <0.001 |
DM | 1294 (16.3) | 41 (3.6) | 12 (2.2) | 29 (4.8) | ||
Glucose AUC (mg·dL −1· h −1) | 1473.5 ± 437.1 | 1181.2 ± 257.8 | < 0.001 | 1180.0 ± 259.7 | 1182.4 ± 256.2 | 0.876 |
Insulin AUC (mg·dL −1· h − 1) | 16,299.7 ± 8297.5 | 13,968.7 ± 7498.6 | < 0.001 | 13,182.2 ± 7277.7 | 14,684.7 ± 7629.9 | 0.001 |
HOMA-IR | 3.8 ± 2.6 | 3.1 ± 2.0 | < 0.001 | 3.1 ± 2.1 | 3.2 ± 1.8 | 0.595 |
Matsuda Index | 2.9 ± 1.9 | 3.8 ± 2.5 | < 0.001 | 4.0 ± 2.7 | 3.6 ± 2.3 | 0.018 |
Insulinogenic index | 25.1 ± 23.0 | 42.9 ± 37.7 | < 0.001 | 36.0 ± 35.9 | 49.1 ± 38.2 | <0.001 |
Disposition index | 12.7 ± 14.1 | 16.6 ± 17.8 | < 0.001 | 13.7 ± 15.4 | 19.2 ± 19.4 | <0.001 |
Comparison of the glucose curve shapes among different age groups
Types of glucose curve shape as the indicator for insulin resistance and β-cell function
NGT(n = 5156) | Prediabetes(n = 2568) | DM(n = 1334) | |||||||
---|---|---|---|---|---|---|---|---|---|
Monophasic (n = 4253) | Multiphasic (n = 903) | P | Monophasic (n = 2362) | Multiphasic (n = 206) | P | Monophasic (n = 1293) | Multiphasic (n = 41) | P | |
Age (years) | 35.1 ± 12.3 | 33.9 ± 12.5 | 0.008 | 41.3 ± 13.6 | 40.1 ± 15.4 | 0.213 | 45.2 ± 13.7 | 46.3 ± 13.9 | 0.598 |
Sex (male/female), n% | 963 (22.6)/3290 (77.4) | 159 (17.6)/744 (82.4) | 0.001 | 682 (28.9)/1680 (71.1) | 53 (25.7)/153 (74.3) | 0.338 | 455 (35.2)/838 (64.8) | 7 (17.1)/34 (82.9) | 0.016 |
FBG (mmol/L) | 5.1 ± 0.5 | 5.1 ± 0.4 | < 0.001 | 5.6 ± 0.6 | 5.5 ± 0.6 | < 0.001 | 7.0 ± 1.7 | 6.4 ± 1.2 | 0.943 |
30 min (mmol/L) | 8.5 ± 1.3 | 7.9 ± 1.3 | < 0.001 | 9.9 ± 1.5 | 9.3 ± 1.3 | < 0.001 | 11.9 ± 2.4 | 12.0 ± 2.2 | 0.962 |
2hPG (mmol/L) | 6.1 ± 0.9 | 5.6 ± 1.2 | < 0.001 | 7.8 ± 1.7 | 8.8 ± 1.2 | < 0.001 | 13.8 ± 3.3 | 12.6 ± 2.7 | 0.017 |
FINS | 13.8 ± 8.0 | 13.0 ± 7.7 | 0.008 | 15.6 ± 8.5 | 15.2 ± 8.4 | 0.578 | 17.0 ± 10.4 | 15.3 ± 8.0 | 0.301 |
30 min INS | 112.0 ± 61.6 | 124.1 ± 68.0 | < 0.001 | 91.9 ± 54.4 | 127.9 ± 63.5 | < 0.001 | 61.7 ± 42.8 | 87.9 ± 53.6 | 0.003 |
2 h INS | 88.1 ± 57.0 | 66.7 ± 50.5 | < 0.001 | 133.8 ± 68.7 | 115.9 ± 67.8 | < 0.001 | 119.9 ± 73.7 | 100.6 ± 64.3 | 0.098 |
Glucose AUC (mg·dL −1· h −1) | 1197.1 ± 158.0 | 1094.1 ± 152.8 | < 0.001 | 1563.7 ± 163.9 | 1398.0 ± 158.4 | < 0.001 | 2219.0 ± 462.6 | 2010.2 ± 368.5 | 0.004 |
Insulin AUC (mg·dL −1· h − 1) | 15,411.0±7733.0 | 13,198.7±7054.3 | < 0.001 | 18,336.3±8582.0 | 17,218.6±8506.1 | 0.073 | 15,514.8±8888.9 | 14,599.2±7349.0 | 0.514 |
HOMA-IR | 3.2 ± 1.9 | 3.0 ± 1.8 | 0.002 | 3.9 ± 2.3 | 3.7 ± 2.1 | 0.199 | 5.4 ± 4.1 | 4.4 ± 2.8 | 0.138 |
Matsuda Index | 3.3 ± 1.9 | 4.1 ± 2.6 | < 0.001 | 2.5 ± 1.6 | 2.8 ± 1.5 | 0.004 | 2.3 ± 1.8 | 2.6 ± 1.4 | 0.419 |
Insulinogenic index | 33.1 ± 26.6 | 46.4 ± 39.6 | < 0.001 | 19.2 ± 13.5 | 32.9 ± 26.7 | < 0.001 | 9.4 ± 7.8 | 13.9 ± 10.3 | < 0.001 |
Disposition index | 15.1 ± 16.0 | 17.0 ± 18.2 | 0.001 | 11.7 ± 11.7 | 16.5 ± 17.0 | < 0.001 | 6.9 ± 8.5 | 7.6 ± 7.1 | 0.594 |
OGTT glucose peak time, nadir time, and insulin peak time in relation to insulin resistant and β-cell function
OGTT glucose nadir at 60 min (n = 688) | OGTT glucose nadir at 120 min (n = 462) | P | |
---|---|---|---|
Age (years) | 35.5 ± 13.2 | 35.3 ± 13.8 | 0.824 |
Sex (male/female), n% | 119 (17.3)/569 (82.7) | 100 (21.6)/362 (78.4) | 0.066 |
FBG (mmol/L) | 5.2 ± 0.6 | 5.2 ± 0.6 | 0.069 |
30 min GLU(mmol/L) | 8.2 ± 1.6 | 8.5 ± 1.6 | 0.004 |
2 h GLU(mmol/L) | 7.1 ± 2.0 | 5.2 ± 1.6 | <0.001 |
FINS | 13.5 ± 7.4 | 13.4 ± 8.6 | 0.743 |
30 min INS | 137.7 ± 67.5 | 102.3 ± 60.6 | <0.001 |
2 h INS | 92.6 ± 61.3 | 53.2 ± 42.3 | <0.001 |
Glycemic status(%) | |||
NGT(%) | 489 (71.1) | 414 (89.6) | |
IFG/IGT/IFG + IGT(%) | 167 (24.3) | 39 (8.4) | < 0.001 |
DM(%) | 32 (4.7) | 9 (1.9) | |
Glucose AUC (mg·dL −1· h −1) | 1175.3 ± 267.0 | 1190.0 ± 243.4 | 0.342 |
Insulin AUC(mg·dL − 1· h − 1) | 14,349.1 ± 7572.7 | 13,402.2 ± 7358.6 | 0.036 |
HOMAIR | 3.1 ± 1.8 | 3.1 ± 2.2 | 0.957 |
Matsuda Index | 3.8 ± 2.5 | 3.8 ± 2.4 | 0.670 |
Insulinogenic index | 49.7 ± 40.8 | 32.7 ± 29.7 | <0.001 |
Disposition index | 18.8 ± 19.0 | 13.1 ± 15.3 | <0.001 |
OGTT glucose peak at 30 min (n = 4599) | OGTT glucose peak at 60 min (n = 3912) | OGTT glucose peak at 120 min (n = 548) | P | |
---|---|---|---|---|
Age (years) | 35.8 ± 12.8 | 40.1 ± 13.6 | 44.9 ± 14.9 | <0.001 |
Sex (male/female), n% | 974 (21.2)/3625 (78.8) | 1178 (30.1)/2734 (69.9) | 167 (30.5)/381 (69.5) | <0.001 |
FBG(mmol/L) | 5.2 ± 0.6 | 5.7 ± 1.1 | 6.6 ± 2.0 | <0.001 |
30 min GLU(mmol/L) | 8.8 ± 1.6 | 9.8 ± 2.1 | 10.6 ± 3.0 | <0.001 |
2 h GLU(mmol/L) | 6.3 ± 1.5 | 8.9 ± 2.8 | 14.4 ± 4.3 | <0.001 |
FINS | 13.6 ± 7.7 | 15.6 ± 9.2 | 16.5 ± 10.3 | <0.001 |
30 min INS | 121.8 ± 63.6 | 82.0 ± 50.1 | 62.6 ± 48.3 | <0.001 |
2 h INS | 85.9 ± 58.8 | 121.5 ± 68.9 | 116.0 ± 73.2 | <0.001 |
Glycemic status(%) | ||||
NGT(%) | 3749 (81.5) | 1386 (35.4) | 21 (3.8) | |
IFG/IGT/IFG + IGT(%) | 766 (16.7) | 1693 (43.3) | 109 (19.9) | < 0.001 |
DM(%) | 84 (1.8) | 833 (21.3) | 418 (76.3) | |
Glucose AUC (mg·dL −1· h −1) | 1202.6 ± 212.3 | 1609.3 ± 385.4 | 2163.9 ± 643.5 | <0.001 |
Insulin AUC(mg·dL −1· h − 1) | 15,048.7 ± 7705.2 | 17,313.6 ± 8561.2 | 14,668.6 ± 8865.8 | <0.001 |
HOMAIR | 3.2 ± 1.9 | 4.1 ± 2.8 | 4.9 ± 3.9 | <0.001 |
Matsuda Index | 3.4 ± 2.1 | 2.6 ± 1.7 | 2.8 ± 2.1 | <0.001 |
Insulinogenic index | 36.1 ± 30.0 | 18.8 ± 16.2 | 15.0 ± 20.9 | <0.001 |
Disposition index | 15.6 ± 16.2 | 11.0 ± 12.4 | 8.6 ± 12.6 | <0.001 |
OGTT insulin peak at 30 min (n = 2935) | OGTT insulin peak at 60 min (n = 3729) | OGTT insulin peak at 120 min (n = 2279) | OGTT insulin peak at 180 min (n = 116) | P | |
---|---|---|---|---|---|
Age (years) | 36.1 ± 13.5 | 37.9 ± 13.1 | 41.3 ± 13.9 | 39.7 ± 14.4 | <0.001 |
Sex (male/female), n% | 610 (20.8)/2325 (79.2) | 1073 (28.8)/2656 (71.2) | 611 (26.8)/1668 (73.2) | 25 (21.2)/91 (78.8) | <0.001 |
FBG(mmol/L) | 5.2 ± 1.0 | 5.5 ± 1.0 | 5.9 ± 1.2 | 6.3 ± 1.6 | <0.001 |
30 min GLU(mmol/L) | 8.6 ± 1.7 | 9.4 ± 2.0 | 10.1 ± 2.0 | 10.2 ± 2.6 | <0.001 |
2 h GLU(mmol/L) | 6.9 ± 2.4 | 7.1 ± 2.6 | 10.3 ± 3.3 | 12.9 ± 4.2 | <0.001 |
FINS | 13.7 ± 7.9 | 14.8 ± 8.8 | 15.5 ± 8.8 | 17.2 ± 11.2 | <0.001 |
30 min INS | 133.0 ± 66.1 | 95.4 ± 54.9 | 71.3 ± 43.7 | 56.4 ± 35.1 | <0.001 |
2 h INS | 85.5 ± 59.7 | 89.6 ± 56.4 | 147.2 ± 70.6 | 117.0 ± 62.9 | <0.001 |
Glycemic status(%) | |||||
NGT(%) | 2211 (75.3) | 2514 (67.4) | 424 (18.6) | 7 (5.3) | |
IFG/IGT/IFG + IGT(%) | 549 (18.7) | 893 (24.0) | 1089 (47.8) | 38 (32.7) | < 0.001 |
DM(%) | 175 (6.0) | 322 (8.6) | 766 (33.6) | 71 (61.9) | |
Glucose AUC (mg·dL −1· h −1) | 1239.8 ± 329.6 | 1389.2 ± 362.0 | 1738.5 ± 440.9 | 2070.4 ± 580.7 | <0.001 |
Insulin AUC(mg·dL −1· h − 1) | 14,403.2 ± 7536.1 | 16,046.0 ± 8141.5 | 17,980.4 ± 8741.5 | 17,006.3 ± 8977.3 | <0.001 |
HOMAIR | 3.3 ± 2.1 | 3.7 ± 2.6 | 4.2 ± 2.8 | 5.1 ± 4.5 | <0.001 |
Matsuda Index | 3.5 ± 2.2 | 2.9 ± 1.9 | 2.6 ± 1.8 | 2.8 ± 2.6 | <0.001 |
Insulinogenic index | 41.8 ± 33.4 | 23.9 ± 19.4 | 15.1 ± 13.5 | 11.7 ± 10.2 | <0.001 |
Disposition index | 17.4 ± 17.6 | 12.7 ± 13.5 | 9.0 ± 10.7 | 6.7 ± 7.1 | <0.001 |
Change in the OGTT glucose curve shape and risk of impaired glucose metabolism
Stable | Unstable | P value | |||
---|---|---|---|---|---|
Monophasic | Multiphasic | Monophasic to Multiphasic | Multiphasic to Monophasic | ||
N | 371 | 9 | 55 | 67 | |
Age (years) | 35.5 ± 12.3 | 37.0 ± 11.3 | 32.9 ± 13.2 | 35.1 ± 14.6 | 0.535 |
Sex (male/female, %) | 62 (16.7)/309 (83.3) | 2 (22.2)/7 (77.8) | 9 (16.4)/46 (83.6) | 9 (13.4)/58 (86.6) | 0.878 |
FBG(mmol/L) | 5.6 ± 0.9 | 5.1 ± 0.6 | 5.2 ± 0.6 | 5.2 ± 0.5 | < 0.001 |
30 min GLU(mmol/L) | 9.2 ± 1.7 | 8.2 ± 1.4 | 8.5 ± 1.3 | 8.3 ± 1.4 | < 0.001 |
2 h GLU(mmol/L) | 8.1 ± 2.7 | 5.6 ± 1.2 | 6.5 ± 1.6 | 6.5 ± 1.7 | < 0.001 |
FINS | 17.7 ± 9.2 | 11.1 ± 5.3 | 15.4 ± 10.0 | 16.8 ± 9.7 | 0.075 |
30 min INS | 111.2 ± 65.3 | 152.8 ± 69.7 | 131.2 ± 74.8 | 150.2 ± 67.7 | < 0.001 |
2 h INS | 128.8 ± 72.2 | 69.3 ± 46.7 | 101.7 ± 66.9 | 97.0 ± 65.7 | < 0.001 |
Glycemic status(n,%) | |||||
NGT | 181 (48.8) | 9 (100) | 42 (76.4) | 51 (76.1) | |
IFG/IGT/IFG + IGT | 145 (39.1) | 0 | 12 (21.8) | 16 (23.9) | < 0.001 |
DM | 45 (12.1) | 0 | 1 (1.8) | 0 | |
Glucose AUC (mg·dL −1· h −1) | 1461.3 ± 366.0 | 1100.2 ± 83.1 | 1230.5 ± 231.0 | 1184.8 ± 208.6 | < 0.001 |
Insulin AUC (mg·dL −1· h − 1) | 19,184.5 ± 8734.1 | 13,817.2 ± 5128.2 | 17,677.0 ± 90,944.7 | 18,637.6 ± 8730.2 | 0.068 |
HOMA-IR | 4.4 ± 2.6 | 2.6 ± 1.2 | 3.6 ± 2.4 | 3.9 ± 2.3 | 0.012 |
Matsuda Index | 2.4 ± 1.6 | 3.8 ± 2.3 | 3.1 ± 2.0 | 3.1 ± 2.0 | < 0.001 |
Insulinogenic index | 29.6 ± 28.3 | 52.8 ± 34.1 | 37.7 ± 23.7 | 55.2 ± 56.7 | < 0.001 |
Disposition index | 17.2 ± 17.3 | 16.3 ± 7.0 | 19.2 ± 18.2 | 24.3 ± 20.4 | 0.025 |
Glycemic status | Improve | Unchanging | Aggravation | Total | |
---|---|---|---|---|---|
Change of the phase-number | Decrease | 7 (10.4%) | 49 (73.1%) | 11 (16.4%) | 67 |
Unchanging | 65 (17.1%) | 245 (64.5%) | 70 (18.4%) | 380 | |
Increase | 11 (20.0%) | 38 (69.1%) | 6 (10.9%) | 55 | |
Total | 83 | 332 | 87 | 502 |