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PLoS One. 2014 Oct 27;9(10):e109702. doi: 10.1371/journal.pone.0109702. eCollection 2014.

Factors associated with beta-cell dysfunction in type 2 diabetes: the BETADECLINE study.

Author information

1
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
2
Metabolism and Diabetes Unit ASL TO5, Chieri, Italy.
3
MSD, Rome, Italy.
4
Department of Clinical Pharmacology and Epidemiology Fondazione Mario Negri Sud, S. Maria Imbaro, Italy.

Abstract

AIMS:

Beta-cell dysfunction is an early event in the natural history of type 2 diabetes. However, its progression is variable and potentially influenced by several clinical factors. We report the baseline data of the BetaDecline study, an Italian prospective multicenter study on clinical predictors of beta-cell dysfunction in type 2 diabetes.

MATERIALS AND METHODS:

Clinical, lifestyle, and laboratory data, including circulating levels of inflammatory markers and non-esterified fatty acids, were collected in 507 type 2 diabetic outpatients on stable treatment with oral hypoglycemic drugs or diet for more than 1 year. Beta-cell dysfunction was evaluated by calculating the proinsulin/insulin ratio (P/I).

RESULTS:

At baseline, the subjects in the upper PI/I ratio quartile were more likely to be men and receiving secretagogue drugs; they also showed a borderline longer diabetes duration (P = 0.06) and higher serum levels of glycated hemoglobin (HbA1c), fasting blood glucose, and triglycerides. An inverse trend across all PI/I quartiles was noted for BMI and serum levels of total cholesterol (T-C), LDL-C, HDL-C and C reactive protein (CRP), and with homeostatic model assessment (HOMA-B) and HOMA of insulin resistance (HOMA-IR) values (P<0.05 for all). At multivariate analysis, the risk of having a P/I ratio in the upper quartile was higher in the subjects on secretagogue drugs (odds ratio [OR] 4.2; 95% confidence interval [CI], 2.6-6.9) and in the males (OR 1.8; 95% CI, 1.1-2.9).

CONCLUSIONS:

In the BetaDecline study population, baseline higher PI/I values, a marker of beta-cell dysfunction, were more frequent in men and in patients on secretagogues drugs. Follow-up of this cohort will allow the identification of clinical predictors of beta-cell failure in type 2 diabetic outpatients.

PMID:
25347846
PMCID:
PMC4210056
DOI:
10.1371/journal.pone.0109702
[Indexed for MEDLINE]
Free PMC Article

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