Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea.
Endocrinol Metab (Seoul). 2024 Oct;39(5):711-721. doi: 10.3803/EnM.2024.1986. Epub 2024 Aug 30.
To evaluate whether insulin resistance and impaired insulin secretion are useful predictors of incident diabetes in Koreans using nationwide population-representative data to enhance data privacy.
This study analyzed the data of individuals without diabetes aged >40 years from the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2010 and 2015 and the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). Owing to privacy concerns, these databases cannot be linked using direct identifiers. Therefore, we generated 10 synthetic datasets, followed by statistical matching with the NHIS-HEALS. Homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of β-cell function (HOMA-β) were used as indicators of insulin resistance and insulin secretory function, respectively, and diabetes onset was captured in NHIS-HEALS.
A median of 4,580 (range, 4,463 to 4,761) adults were included in the analyses after statistical matching of 10 synthetic KNHANES and NHIS-HEALS datasets. During a mean follow-up duration of 5.8 years, a median of 4.7% (range, 4.3% to 5.0%) of the participants developed diabetes. Compared to the reference low-HOMA-IR/high-HOMA-β group, the high-HOMA-IR/low- HOMA-β group had the highest risk of diabetes, followed by high-HOMA-IR/high-HOMA-β group and low-HOMA-IR/low- HOMA-β group (median adjusted hazard ratio [ranges]: 3.36 [1.86 to 6.05], 1.81 [1.01 to 3.22], and 1.68 [0.93 to 3.04], respectively).
Insulin resistance and impaired insulin secretion are robust predictors of diabetes in the Korean population. A retrospective cohort constructed by combining cross-sectional synthetic and longitudinal claims-based cohort data through statistical matching may be a reliable resource for studying the natural history of diabetes.
本研究旨在利用全国代表性人群数据评估胰岛素抵抗和胰岛素分泌受损是否可作为韩国人发生糖尿病的有用预测指标，以增强数据隐私性。
本研究分析了 2007-2010 年和 2015 年韩国国家健康和营养检查调查（KNHANES）以及国家健康保险服务-国家健康筛查队列（NHIS-HEALS）中无糖尿病的>40 岁个体的数据。由于隐私问题，这些数据库不能使用直接标识符进行链接。因此，我们生成了 10 个合成数据集，然后使用 NHIS-HEALS 进行统计匹配。稳态模型评估的胰岛素抵抗（HOMA-IR）和稳态模型评估的β细胞功能（HOMA-β）分别作为胰岛素抵抗和胰岛素分泌功能的指标，NHIS-HEALS 中记录了糖尿病的发病情况。
在对 10 个合成的 KNHANES 和 NHIS-HEALS 数据集进行统计匹配后，中位数为 4580 名（范围：4463 至 4761）成年人纳入分析。在平均 5.8 年的随访期间，中位数为 4.7%（范围：4.3%至 5.0%）的参与者发生糖尿病。与低 HOMA-IR/高 HOMA-β的参考组相比，高 HOMA-IR/低 HOMA-β组的糖尿病发病风险最高，其次是高 HOMA-IR/高 HOMA-β组和低 HOMA-IR/低 HOMA-β组（中位数调整后的风险比[范围]：3.36 [1.86 至 6.05]、1.81 [1.01 至 3.22]和 1.68 [0.93 至 3.04]）。
胰岛素抵抗和胰岛素分泌受损是韩国人群发生糖尿病的有力预测指标。通过统计匹配将横断面合成数据和纵向基于索赔的队列数据相结合构建的回顾性队列可能是研究糖尿病自然史的可靠资源。
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