Genki Plaza Medical Center for Health Care, Tokyo, Japan.
Department of Physical Therapy, Faculty of Makuhari Human Care, Tohto University, Chiba, Japan.
J Diabetes Investig. 2024 Feb;15(2):177-185. doi: 10.1111/jdi.14092. Epub 2023 Oct 10.
AIMS/INTRODUCTION: The aim of this study was to clarify the characteristics of individuals with prediabetes who developed type 2 diabetes despite undergoing interventions, and to evaluate the performance of urinary myo-inositol (UMI) as a noninvasive indicator for the risk of developing diabetes.
A total of 51 individuals with prediabetes who underwent a 75-g oral glucose tolerance test, ΔUMI (the difference in the UMI : creatinine ratio between before and 120 min after 75-g glucose loading), fasting plasma glucose, insulin, hemoglobin A1c, noninvasive testing (age, body mass index, blood pressure) and general blood tests were measured at baseline, and underwent dietary/exercise guidance for 8 years were studied.
A total of 31 participants developed diabetes in 8 years. At baseline, the group that developed diabetes was characterized by high ΔUMI, hemoglobin A1c, fasting plasma glucose and low high-density lipoprotein cholesterol, and insulinogenic index (I.I.). I.I and ΔUMI showed a higher correlation than fasting plasma glucose and hemoglobin A1c. Regarding diabetes onset within 8 years, Cox regression analysis of diabetes onset showed the baseline ΔUMI is an independent predictor, adjusted for the result of not only noninvasive markers, but also that of noninvasive and general blood markers. The log-rank test showed that all glycemic indicators were significantly associated with diabetes onset.
Participants who developed type 2 diabetes from prediabetes despite undergoing interventions were characterized by high glycemic control markers and low I.I. As noninvasive measurement of ΔUMI is associated with I.I. and diabetes onset, it could be a useful indicator for identifying individuals with a high risk of diabetes onset.
目的/引言：本研究旨在阐明尽管进行了干预，但仍发展为 2 型糖尿病的糖尿病前期个体的特征，并评估尿肌醇（UMI）作为一种非侵入性指标预测糖尿病发病风险的性能。
共纳入 51 例糖尿病前期患者，进行 75g 口服葡萄糖耐量试验，测量空腹血糖、胰岛素、糖化血红蛋白（HbA1c）、非侵入性检查（年龄、体重指数、血压）和一般血液检查。同时测量基线时的尿肌醇（UMI）：75g 葡萄糖负荷后 120 分钟与负荷前的 UMI 与肌酐的差值（ΔUMI），以及接受 8 年饮食/运动指导。
共有 31 名参与者在 8 年内发展为糖尿病。基线时，发展为糖尿病的组具有较高的ΔUMI、HbA1c、空腹血糖和较低的高密度脂蛋白胆固醇和胰岛素生成指数（I.I.）。与空腹血糖和 HbA1c 相比，I.I.和 ΔUMI 的相关性更高。关于 8 年内的糖尿病发病，糖尿病发病的 Cox 回归分析显示，ΔUMI 是独立的预测因素，不仅调整了非侵入性标志物的结果，还调整了非侵入性和一般血液标志物的结果。对数秩检验显示，所有血糖指标均与糖尿病发病显著相关。
尽管进行了干预，但仍从糖尿病前期发展为 2 型糖尿病的参与者的血糖控制标志物较高，I.I.较低。由于 ΔUMI 的非侵入性测量与 I.I.和糖尿病发病相关，因此它可能是识别糖尿病发病风险较高个体的有用指标。
