Insulin resistance contributes more to the increased risk for diabetes development in subjects with low lipoprotein(a) level than insulin secretion.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Insulin Resistance*; Diabetes Mellitus/*epidemiology ; Diabetes Mellitus/*etiology ; Insulin/*blood ; Lipoprotein(a)/*blood; Adult ; Biomarkers ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk

Background: Recent studies suggest an association between Lipoprotein(a) [Lp(a)] and the development of diabetes mellitus. We analyzed the association between baseline Lp(a) levels and diabetes development after 4 years of follow-up, in a population of apparently healthy Korean subjects.
Methods: A total of 2,536 non-diabetic participants (mean age: 41 years, men: 92%) of a health checkup program were included in the study. Diabetes development was defined by fasting blood glucose ≥126 mg/dL, HbA1c ≥6.5%, and self-reported treatment of diabetes. Homeostasis model assessment (HOMA) indices were used to assess insulin resistance (IR) and insulin secretion (IS). Presence of IR and impaired IS was defined by being in the highest quartile of HOMA-IR and in the lowest quartile HOMA-IS.
Results: After four years, 3.4% of the participants developed diabetes. The odds ratio (OR) of developing diabetes was lowest in the 4th quartile group of baseline Lp(a) (0.323 [95% CI 0.153-0.685])with the 1st quartile group as the reference. The subjects with both IR & impaired IS plus baseline Lp(a)<50 mg/dL showed the higher OR for diabetes development compared with those without IR and normal IS as the reference (67.277 [20.218-223.871], and those with IR plus Lp(a)<50 mg/dL showed higher OR for diabetes than in those with impaired IS and Lp(a)<50 mg/dL (3.811 [1.938-7.495] vs. 3.452 [1.620-7.353]).
Conclusions: The subjects with low baseline Lp(a) level showed higher risk for development of diabetes compared with high baseline Lp(a) level, and this was prominent in those with IR than in those with impaired IS.

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0 (Biomarkers)
0 (Insulin)
0 (Lipoprotein(a))

Date Created: 20170517 Date Completed: 20170906 Latest Revision: 20181113

20231215

PMC5433708

10.1371/journal.pone.0177500

28510610