Skip to main content
SpringerLink
Log in

Impact of metabolic syndrome on the incidence of type 2 diabetes in middle-aged Japanese individuals with impaired insulin secretion: the Saku study

  • Original Article
  • Published:
Diabetology International Aims and scope Submit manuscript

Abstract

Aims

To assess the impact of metabolic syndrome (MetS) on the incidence of type 2 diabetes in middle-aged Japanese individuals with impaired insulin secretion (IIS).

Methods

This cohort study included 1,702 individuals aged 40–59 without diabetes at baseline who underwent a comprehensive medical check-up between April 2008 and March 2009 at Saku Central Hospital. Participants were classified according to their IIS and insulin resistance (IR) status [normal, isolated IR (i-IR), or isolated IIS (i-IIS)] and MetS (presence or absence). They were followed up until March 2014. Type 2 diabetes was defined based on fasting and 2-h post-load plasma glucose concentrations and by the receipt of medical treatment for diabetes.

Results

During 7,572 person-years of follow-up, 92 individuals developed type 2 diabetes. The incidence rates (/1,000 person-years) for type 2 diabetes in the normal without MetS, normal with MetS, i-IR without MetS, i-IR with MetS, i-IIS without MetS, and i-IIS with MetS groups were 5.3, 3.7, 11.3, 24.7, 16.7, and 59.5, respectively. The multivariable-adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) for type 2 diabetes in the normal with MetS, i-IR with MetS, and i-IIS with MetS groups, relative to the normal without MetS group, were 0.52 (0.12–2.25), 3.78 (1.93–7.42), and 7.94 (3.96–15.91), respectively. Additionally, a positive association of MetS with type 2 diabetes was observed in the i-IIS group [HR (95 % CI) 3.56 (1.88–6.73)] but not in the normal and i-IR groups.

Conclusions

The prevention of MetS is important, particularly in individuals with low insulin secretion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2a–c

Similar content being viewed by others

References

  1. Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet. 2011;378:31–40.

    Article  CAS  PubMed  Google Scholar 

  2. Wild S, Roglic G, Green A, Sicree R, King G. Global prevalence of diabetes. Estimates for the year 2000 and projections for 2030. Diabet Care. 2004;27:1047–53.

    Article  Google Scholar 

  3. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabet Res Clin Pract. 2014;103:137–49.

    Article  CAS  Google Scholar 

  4. Kahn SE. The relative contribution of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes. Diabetologia. 2003;46:3–19.

    Article  CAS  PubMed  Google Scholar 

  5. Martin BC, Warram JH, Krolewski AS, Bergman RN, Soeldner JS, Kahn CR. Role of glucose and insulin resistance in development of type 2 diabetes mellitus: results of a 25-year follow-up study. Lancet. 1992;340:925–9.

    Article  CAS  PubMed  Google Scholar 

  6. Kodama K, Tojjar D, Yamada S, Toda K, Patel CJ, Butte AJ. Ethnic differences in the relationship between insulin sensitivity and insulin response: a systematic review and meta-analysis. Diabet Care. 2013;36:1789–96.

    Article  CAS  Google Scholar 

  7. Ahuja V, Kadowaki T, Evans RW, Kadota A, Okamura T, El Khoudary SR, et al. Comparison of HOMA-IR, HOMA-β% and disposition index between US white men and Japanese men in Japan: the ERA JUMP study. Diabetologia. 2015;58:265–71.

    Article  PubMed  Google Scholar 

  8. Yabe D, Seino Y, Fukushima M, Seino S. β cell dysfunction versus insulin resistance in the pathogenesis of type 2 diabetes in East Asians. Curr Diabet Rep. 2015;15:602.

    Article  Google Scholar 

  9. Morimoto A, Tatsumi Y, Deura K, Mizuno S, Ohno Y, Miyamatsu N, et al. Impact of impaired insulin secretion and insulin resistance on the incidence of type 2 diabetes mellitus in a Japanese population: the Saku study. Diabetologia. 2013;56:1671–9.

    Article  CAS  PubMed  Google Scholar 

  10. Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009;301:2129–40.

    Article  CAS  PubMed  Google Scholar 

  11. Lorenzo C, Okoloise M, Williams K, Stern MP, Haffner SM, San Antonio Heart Study. The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study. Diabet Care. 2003;26:3153–9.

    Article  Google Scholar 

  12. Sattar N, McConnachie A, Shaper AG, Blauw GJ, Buckley BM, de Craen AJ, et al. Can metabolic syndrome usefully predict cardiovascular disease and diabetes? Outcome data from two prospective studies. Lancet. 2008;371:1927–35.

    Article  PubMed  Google Scholar 

  13. Tatsumi Y, Morimoto A, Miyamatsu N, Noda M, Ohno Y, Deura K. Effect of body mass index on insulin secretion or sensitivity and diabetes. Am J Prev Med. 2015;48:128–35.

    Article  PubMed  Google Scholar 

  14. Tatsumi Y, Morimoto A, Soyano F, Shimoda T, Miyamatsu N, Ohno Y, et al. Risk of proteinuria among individuals with persistent borderline diabetes: the Saku study. Diabetol Int. 2016;7(2)181–87. doi:10.1007/s13340-015-0235-x.

  15. Seltzer HS, Allen EW, Herron AL Jr, Brennan MT. Insulin secretion in response to glycemic stimulus: relation of delayed initial release to carbohydrate intolerance in mild diabetes mellitus. J Clin Invest. 1967;46:323–35.

  16. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.

    Article  CAS  PubMed  Google Scholar 

  17. Seino Y, Nanjo K, Tajima N, Kadowaki T, Kashiwagi A, et al. Report of the Committee on the classification and diagnostic criteria of diabetes mellitus. J Diabet Invest. 2010;1:212–28.

  18. The Japan Diabetes Society. Evidence-based practice guideline for the treatment of diabetes in Japan. Tokyo: Nankodo; 2013 (in Japanese).

    Google Scholar 

  19. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1640–5.

    Article  CAS  PubMed  Google Scholar 

  20. World Health Organization. Report of a WHO Consultation: definition, diagnosis and classification of diabetes mellitus and its complications: Part 1. Geneva: Department of Noncommunicable Disease Surveillance; 1999.

  21. The Examination Committee for Criteria of Metabolic Syndrome. Definition and criteria of metabolic syndrome. J Jpn Soc Int Med. 2005;94:794–809 (in Japanese).

    Article  Google Scholar 

  22. Ilanne-Parikka P, Eriksson JG, Lindström J, Peltonen M, Aunola S, Hämäläinen H, et al. Effect of lifestyle intervention on the occurrence of metabolic syndrome and its components in the Finnish Diabetes Prevention Study. Diabet Care. 2008;31:805–7.

    Article  Google Scholar 

  23. Orchard TJ, Temprosa M, Goldberg R, Haffner S, Ratner R, Marcovina S, et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med. 2005;142:611–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Tatsumi Y, Morimoto A, Deura K, Ohno Y, Miyamatsu N, Mizuno S, et al. Weight gain and the incidence of type 2 diabetes among individuals with impaired insulin secretion: the Saku study. Jpn J Cardiovasc Dis Prev. 2013;48:210–5 (in Japanese).

    Google Scholar 

  25. Yabe D, Seino Y. Type 2 diabetes via β-cell dysfunction in east Asian people. Lancet Diabet Endocrinol. 2016;4:2–3.

    Article  Google Scholar 

  26. Ohn JH, Kwak SH, Cho YM, Lim S, Jang HC, Park KS, et al. 10-Year trajectory of β-cell function and insulin sensitivity in the development of type 2 diabetes: a community-based prospective cohort study. Lancet Diabet Endocrinol. 2016;4:27–34.

  27. Rattarasarn C, Soonthornpan S, Leelawattana R, Setasuban W. Decreased insulin secretion but not insulin sensitivity in normal glucose tolerant Thai subjects. Diabet Care. 2006;29:742–3.

    Article  Google Scholar 

  28. Fukushima M, Suzuki H, Seino Y. Insulin secretion capacity in the development from normal glucose tolerance to type 2 diabetes. Diabet Res Clin Pract. 2004;66(Suppl 1):S37–43.

    Article  CAS  Google Scholar 

  29. Matsumoto K, Miyake S, Yano M, Ueki Y, Yamaguchi Y, Akazawa S, et al. Glucose tolerance, insulin secretion, and insulin sensitivity in nonobese and obese Japanese subjects. Diabet Care. 1997;20:1562–8.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The authors sincerely thank Dr. K. Deura (Saku Central Hospital, Saku, Japan), Ms. F. Soyano (Saku University, Saku, Japan), and Ms. F. Sato (Saku Central Hospital, Saku, Japan) for their contributions to the Saku study. This work was supported by a Japan Society for the Promotion of Science (JSPS) Grant-in-Aid for Research Activity Start-up (Grant No. 25882019) and a JSPS Grant-in-Aid for Young Scientists (B) (Grant No. 15K16513).

Author information

Authors and Affiliations

  1. Department of Clinical Nursing, Shiga University of Medical Science, Tsukinowa-cho Seta, Otsu, Shiga, 520-2192, Japan

    Akiko Morimoto & Naomi Miyamatsu

  2. Department of Hygiene and Public Health, Teikyo University, 2-11-1 Kaga, Itabashi-Ku, Tokyo, 173-8605, Japan

    Yukako Tatsumi

  3. Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, 1-7 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Nao Sonoda

  4. Saku Central Hospital, 197 Usuda, Saku, Nagano, 384-0301, Japan

    Tetsuo Shimoda & Shiro Sakaguchi

Authors
  1. Akiko Morimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yukako Tatsumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nao Sonoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Naomi Miyamatsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tetsuo Shimoda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shiro Sakaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akiko Morimoto.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Human rights statement and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revisions. Informed consent or a substitute for it was obtained from all participants before they were included in the study.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 43 kb)

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Morimoto, A., Tatsumi, Y., Sonoda, N. et al. Impact of metabolic syndrome on the incidence of type 2 diabetes in middle-aged Japanese individuals with impaired insulin secretion: the Saku study. Diabetol Int 8, 104–111 (2017). https://doi.org/10.1007/s13340-016-0287-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13340-016-0287-6

Keywords

Search

Navigation