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Then, C.* ; Gar, C. ; Thorand, B. ; Huth, C. ; Then, H.* ; Meisinger, C. ; Heier, M. ; Peters, A. ; Koenig, W.* ; Rathmann, W.* ; Lechner, A. ; Seissler, J.

Proinsulin to insulin ratio is associated with incident type 2 diabetes but not with vascular complications in the KORA F4/FF4 study.

BMJ Open Diab. Res. Care 8:e001425 (2020)
Verlagsversion DOI
Open Access Gold
Creative Commons Lizenzvertrag
Introduction We investigated the association of the proinsulin to insulin ratio (PIR) with prevalent and incident type 2 diabetes (T2D), components of the metabolic syndrome, and renal and cardiovascular outcomes in the population-based Cooperative Health Research in the Region of Augsburg (KORA) F4 study (2006-2008)/FF4 study (2013-2014).Research design and methods The analyses included 1514 participants of the KORA F4 study at baseline and 1132 participants of the KORA FF4 study after a median follow-up time of 6.6 years. All-cause and cardiovascular mortality as well as cardiovascular events were analyzed after a median time of 9.1 and 8.6 years, respectively. The association of PIR with T2D, renal and cardiovascular characteristics and mortality were assessed using logistic regression models. Linear regression analyses were used to assess the association of PIR with components of the metabolic syndrome.Results After adjustment for sex, age, body mass index (BMI), and physical activity, PIR was associated with prevalent (OR: 2.24; 95% CI 1.81 to 2.77; p<0.001) and incident T2D (OR: 1.66; 95% CI 1.26 to 2.17; p<0.001). PIR was associated with fasting glucose (beta per SD: 0.11 +/- 0.02; p<0.001) and HbA1c (beta: 0.21 +/- 0.02; p<0.001). However, PIR was not positively associated with other components of the metabolic syndrome and was even inversely associated with waist circumference (beta: -0.22 +/- 0.03; p<0.001), BMI (beta: -0.11 +/- 0.03; p<0.001) and homeostatic model assessment of insulin resistance (beta: -0.22 +/- 0.02; p<0.001). PIR was not significantly associated with the intima-media thickness (IMT), decline of kidney function, incident albuminuria, myocardial infarction, stroke, cardiovascular or all-cause mortality.Conclusions In the KORA F4/FF4 cohort, PIR was positively associated with prevalent and incident T2D, but inversely associated with waist circumference, BMI and insulin resistance, suggesting that PIR might serve as a biomarker for T2D risk independently of the metabolic syndrome, but not for microvascular or macrovascular complications.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Diabetes Mellitus ; Type 2 ; Proinsulin ; Metabolic Syndrome ; Mortality; Impaired Glucose-tolerance; Intima-media Thickness; Coronary Heart-disease; Myocardial-infarction; Independent Predictor; Secretory Capacity; Fasting Proinsulin; Cell Dysfunction; Follow-up; Resistance
ISSN (print) / ISBN 2052-4897
e-ISSN 2052-4897
Quellenangaben Band: 8, Heft: 1, Seiten: , Artikelnummer: e001425 Supplement: ,
Verlag BMJ Publishing Group
Verlagsort London
Begutachtungsstatus Peer reviewed
Förderungen German Research Foundation (DFG)
State of Bavaria
Virtual Diabetes Institute (Helmholtz Zentrum Munchen)
Clinical Cooperation Group Diabetes
Ludwig-Maximilians-University Munchen
Helmholtz Zentrum Munchen
German Diabetes Center
Federal Ministry of Health (Berlin, Germany)
Ministry of Culture and Science of the state North Rhine Westphalia (Dusseldorf, Germany)
Deutsche Diabetes Gesellschaft (DDG)
Helmholtz Zentrum Munchen-German Research Center for Environmental Health - German Federal Ministry of Education and Research (BMBF)