Division of Cardiovascular Medicine, Endocrinology and Metabolism, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
School of Health Science, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
PLoS One. 2018 Jul 20;13(7):e0201052. doi: 10.1371/journal.pone.0201052. eCollection 2018.
Screening for undiagnosed type 2 diabetes mellitus is recommended for Asian Americans with a body mass index ≥23. However, the optimal body mass index cut-off score for predicting the risk of diabetes mellitus in Japanese people is not well known. The aim of this study was to determine the best body mass index cut-off score for predicting insulin resistance and diabetes mellitus in the Japanese population.
This study had two parts, a clinical investigation and a retrospective observational investigation. In the clinical part of the study, 58 participants (26 with type 2 diabetes mellitus and 32 non-diabetics) underwent a hyperinsulinemic-euglycemic clamp from which their glucose disposal rate was measured. For the retrospective part of the study, medical check-up data from 88,305 people in the Tottori Prefecture were analyzed for clinical evidence of diabetes mellitus. The optimal BMI cut-off scores for prediction of insulin resistance and diabetes mellitus were determined.
In the clamp study, the optimal body mass index cut-off score to predict insulin resistance in non-diabetic patients was 22.7. All participants with type 2 diabetes mellitus were insulin resistant, and the optimal body mass index cut-off score for prediction of severe insulin resistance was 26.2. When the data from the type 2 diabetic and the non-diabetic participants were combined, the optimal body mass index cut-off score for prediction of insulin resistance was 23.5. Analysis of 88,305 medical check-up records yielded an optimal body mass index cut-off score for prediction of diabetes mellitus of 23.6.
These results suggest that having a body mass index ≥23 is a risk factor for insulin resistance and diabetes mellitus in the Japanese population.
对于身体质量指数（BMI）≥23 的亚裔美国人，建议进行未确诊的 2 型糖尿病筛查。然而，预测日本人糖尿病风险的最佳 BMI 截止分数尚不清楚。本研究旨在确定预测日本人胰岛素抵抗和糖尿病的最佳 BMI 截止分数。
本研究分为两部分，临床研究和回顾性观察研究。在临床研究部分，58 名参与者（26 名 2 型糖尿病患者和 32 名非糖尿病患者）接受了高胰岛素正葡萄糖钳夹试验，从中测量了他们的葡萄糖处置率。对于研究的回顾性部分，分析了来自鸟取县的 88305 人的医疗检查数据，以寻找糖尿病的临床证据。确定了预测胰岛素抵抗和糖尿病的最佳 BMI 截止分数。
在钳夹研究中，预测非糖尿病患者胰岛素抵抗的最佳 BMI 截止分数为 22.7。所有 2 型糖尿病患者均存在胰岛素抵抗，预测严重胰岛素抵抗的最佳 BMI 截止分数为 26.2。当将 2 型糖尿病患者和非糖尿病患者的数据合并时，预测胰岛素抵抗的最佳 BMI 截止分数为 23.5。对 88305 份医疗检查记录的分析得出了预测糖尿病的最佳 BMI 截止分数为 23.6。
这些结果表明，日本人的 BMI≥23 是胰岛素抵抗和糖尿病的危险因素。
