- Insulin Secretion, Insulin Sensitivity and Body Fat Distribution Patterns in Patients with Impaired Glucose Tolerance.
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Jin Hwa Lee, Yeon Ah Sung, Nan Ho Kyung, Yeon Jin Jang
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Korean Diabetes J. 1999;23(5):647-660. Published online January 1, 2001
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 Abstract
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- BACKGROUND
Type 2 diabetes mellitus(DM) is characterized by impaired insulin secretion and decreased insulin sensitivity, and often preceded by impaired glucose tolerance (IGT). To determine the relative importance of impaired insulin secretion and insulin resistance in development of type 2 DM, we evaluated body fat distribution patterns, insulin secretion and sensitivity in patients with IGT. METHODS: Thirty-six patients with IGT and age and weight matched twenty-four control subjects, were recruited from urban diabetes incidence cohort. Fasting serum glucose and insulin were measured. Body fat distribution pattern was assessed by waist to hip ratio (WHR), percent body fat and fat mass measured by bioelectrical impedence analyzer, and visceral to subcutaneous fat ratio (VSR) at the level of umbilicus using the computed tomography. Using insulin modified intravenous glucose tolerance test, insulin sensitivity was measured as minimal model derived sensitivity index (S(I)), and insulin secretion was measured as acute insulin response to glucose (AIR(g)) and beta-cell disposition index (AlR(g) X Sr). RESULT: l) In the patients with IGT, AIR(g)X S(I)(p<0.01) and area under the curve of insulin (AUC(I))(p<0.01) were significantly decreased compared with control subjects and age was greater than control subjects without statistical significance (p=0.17). 2) In the patients with IGT, body fat distribution patterns, indices of insulin secretion and sensitivity were not different according to the presence of family history of DM. AIR, and S(I) were negatively correlated in control subjects (r=-0.38, p=0.08) and the patients with IGT without family history of DM (r=-0.37, p=0.10), but not in the patients with IGT with family history of DM. 3) In the patients with IGT, indices of insulin secretion and sensitivity were not different according to body mass index (BMI). In both obese (BMI>=25 kg/m ) and non-obese (BMI<25 kg/m) patients with IGT, AIR(g)(p<0.05) and AIR(g) X S(I) were significantly decreased compared with control subjects (p<0.01). 4) In control subjects, age (p<0.05) and body fat mass (p<0.05) were significantly associated with AIR(g) X S(I) by multiple regression analysis. In the patients with IGT, body fat mass was significantly associated with AIR(g)(p<0.01) and AUC(I)(p<0.01), and BMI(p<0.01) was significantly associated with S(I). CONCLUSION: In patients with IGT, impaired insulin secretion was more prominent than decreased insulin sensitivity as compared with control subjects regardless of obesity and the presence of family history.
- Prevalence and Risk Factors of Erectile Dysfunction in Diabetic Men by Self-Reported Questionnaires.
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Jin Hwa Lee, Jee Young Oh, Young Sun Hong, Yeon Ah Sung, Nan Ho Kyung, Woo Sik Chung, Eun Young Choi
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Korean Diabetes J. 1998;22(4):538-545. Published online January 1, 2001
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Abstract
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- BACKGROUND
Erectile dysfunction is the consistent inability to achieve or sustain an erection of suffieient rigidity for sexual intercourse. Erectile dysfunction is an important cause of decreased quality of life in diabetic men. The prevalence of ereciile dysfunction has been reported to be three times higher in diabetic men than nondiabetics. Erectile dysfunction in diabetic men has been associated with increased age, poor glycemic control, smoling, alcohol intake, depression, and microvascular diabetic complication. Our purpose was to determine the prevalence of erectile dysfunction in diabetic men and to assess risk factors re]ated to erectile dysfunction in diabetes mellitus. METHODS: From l53 diabetic men visiting Ewha Womans University Hospital from March, 1997 to March, 1998, we analyzed the self-reported questionnaires. Three questions about erection and one question about overall sexual satisfaetion were given and the answer to each question was categorized into 5 degrees according to the severity of sexua] dysfunction. Erectile dysfunction was diagnosed when any answer for erection showed a degree lower than 4. We obtained the history of smoking, alcohol and hypertension, and measured the current weight and height. Fasting glucose, HBA 1c and lipid profile were me measured. We also evaluated for the presence of diabetic retinopathy, nephropathy and neuropathy. RESULTS: 1) The self-reported prevalence of erectile dysfunction in diabetic men was 75.5 % in this study. 2) In the patients with erectile dysfunction, age, duration of diabetes mellitus, HbAlc, and systolic blood pressure were significantly higher, and BMI and triglyceride significantly lower than in the patients without erectile dysfunction. 3) The prevalence of erectile dysfunction was increased with aging and increasing duration of diabetes mellitus, HBA. was significantly positively related and BMI was inversely related to erectile dysfunction. 4) Age and HbA 1c were independently and positively related to erectile dysfunction by multiple logistic regression. 5) The erectile dysfunction was significantly associated with diabetic autonomic neuropathy and retinopathy. CONCLUSION: The prevalence of self-reported erectile dysfunction in diabetic men was 75.5 % in this study, and it was significantly related to aging and the degree of the glycemic control.
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