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Risk factors for type 2 diabetes mellitus preceded by β-cell dysfunction, insulin resistance, or both in older adults: the Cardiovascular Health Study.
Tuesday,2013-08-13 17:34 America/Los_Angeles — eenright
| Title | Risk factors for type 2 diabetes mellitus preceded by β-cell dysfunction, insulin resistance, or both in older adults: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2013 |
| Authors | Imamura, F, Mukamal, KJ, Meigs, JB, Luchsinger, JA, Ix, JH, Siscovick, DS, Mozaffarian, D |
| Journal | Am J Epidemiol |
| Volume | 177 |
| Issue | 12 |
| Start Page | 1418 |
| Pagination | 1418-29 |
| Date Published | 2013 Jun 15 |
| ISSN | 1476-6256 |
| Keywords | Adiposity, Age Factors, Aged, Aged, 80 and over, Aging, Alcohol Drinking, Blood Pressure, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Humans, Incidence, Insulin Resistance, Insulin-Secreting Cells, Lipids, Male, Prospective Studies, Risk Factors, Socioeconomic Factors, United States |
| Abstract | <p>Insulin resistance (IR) and pancreatic β-cell dysfunction lead to type 2 diabetes mellitus (DM). We tested whether risk factors would differ for DM that was preceded predominantly by IR, β-cell dysfunction, or both among 4,384 older adults (mean age, 72.7 (standard deviation, 5.6) years) in the Cardiovascular Health Study, which was conducted in North Carolina, California, Maryland, and Pennsylvania (1989-2007). When evaluating established risk factors, we found older age, greater adiposity, higher systolic blood pressure, a lower high-density lipoprotein cholesterol level, a higher triglyceride level, and a lower alcohol intake to be independently associated with greater IR but, conversely, with better β-cell function (P < 0.001). The prospective associations between some risk factors and incident DM varied significantly depending on whether DM was preceded predominantly by IR, β-cell dysfunction, or both. For example, obesity and lower high-density lipoprotein cholesterol levels were positively associated with DM preceded predominantly by IR (hazard ratio (HR) = 5.02, 95% confidence interval (CI): 2.81, 9.00; and HR = 1.97, 95% CI: 1.32, 2.93, respectively), with a significant association with and an insignificant trend toward a lower risk of DM preceded predominantly by β-cell dysfunction (HR = 0.33, 95% CI: 0.14, 0.80; and HR = 0.78, 95% CI: 0.43, 1.39, respectively). In conclusion, among older adults, DM risk factors were differentially associated with DM preceded predominantly by IR or β-cell dysfunction. Biologic and clinical implications of putative subtypes of DM require further investigation.</p> |
| DOI | 10.1093/aje/kws440 |
| Alternate Journal | Am. J. Epidemiol. |
| PubMed ID | 23707958 |
| PubMed Central ID | PMC3707407 |
| Grant List | P30 AG024827 / AG / NIA NIH HHS / United States R01 HL075366 / HL / NHLBI NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States R01 HL085710 / HL / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States R01-HL085710 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States R01-HL-094555 / HL / NHLBI NIH HHS / United States P30-AG-024827 / AG / NIA NIH HHS / United States R01-HL-075366 / HL / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States R01 HL094555 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States AG-027058 / AG / NIA NIH HHS / United States N01-HC-55222 / HC / NHLBI NIH HHS / United States K24 DK080140 / DK / NIDDK NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States R01-AG-20098 / AG / NIA NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States R01-AG-023629 / AG / NIA NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States 3R01-HL085710-03S1 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States R01-AG-15928 / AG / NIA NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States |