β-cell dysfunction and insulin resistance in relation to pre-diabetes and diabetes among adults in north-western Tanzania: a cross-sectional study.

Autor: PrayGod G; Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania., Filteau S; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK., Range N; Muhimbili Research Centre, National Institute for Medical Research, Dar es Saalam, Tanzania., Kitilya B; Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania., Kavishe BB; Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania., Ramaiya K; Hindu Mandal Hospital, Dar es Salaam, Tanzania., Jeremiah K; Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania., Rehman AM; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK., Changalucha J; Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania., Olsen MF; Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark., Andersen AB; Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark., Friis H; Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark., Krogh-Madsen R; Centre of Inflammation and Metabolism and Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Faurholt-Jepsen D; Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Tropical medicine & international health : TM & IH [Trop Med Int Health] 2021 Apr; Vol. 26 (4), pp. 435-443. Date of Electronic Publication: 2021 Jan 27.
DOI: 10.1111/tmi.13545
Abstrakt: Objective: Studies on phenotypes of diabetes in Africa are inconsistent. We assessed the role of β-cell dysfunction and insulin resistance on pre-diabetes and diabetes.
Methods: We included 1890 participants with mean age of 40.6 (SD11.9) years in a cross-sectional study among male and female adults in Tanzania during 2016 to 2017. Data on C-reactive protein (CRP), alpha-acid glycoprotein (AGP), HIV, oral glucose tolerance test (OGTT), body composition and insulin were collected. Insulinogenic index and HOMA-IR were used to derive an overall marker of β-cell dysfunction and insulin resistance which was categorised as follows: normal β-cell function and insulin sensitivity, isolated β-cell dysfunction, isolated insulin resistance, and combined β-cell dysfunction and insulin resistance. Pre-diabetes and diabetes were defined as 2-hour OGTT glucose between 7.8-11.0 and ≥ 11.1 mmol/L, respectively. Multinomial regression assessed the association of β-cell dysfunction and insulin resistance with outcome measures.
Results: β-cell dysfunction, insulin resistance, and combined β-cell dysfunction and insulin resistance were associated with higher pre-diabetes risk. Similarly, isolated β-cell dysfunction (adjusted relative risk ratio (aRRR) 4.8 (95% confidence interval (CI) 2.5, 9.0), isolated insulin resistance (aRRR 3.2 (95% CI 1.5, 6.9), and combined β-cell dysfunction and insulin resistance (aRRR 35.9 (95% CI 17.2, 75.2) were associated with higher diabetes risk. CRP, AGP and HIV were associated with higher diabetes risk, but fat mass was not. 31%, 10% and 33% of diabetes cases were attributed to β-cell dysfunction, insulin resistance, and combined β-cell dysfunction and insulin resistance, respectively.
Conclusions: β-cell dysfunction seemed to explain most of diabetes cases compared to insulin resistance in this population. Cohort studies on evolution of diabetes in Africa are needed to confirm these results.
(© 2021 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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