Hormonal
In older adults, obesity and low HDL cholesterol significantly increase the risk of type 2 diabetes preceded by insulin resistance, but are associated with a lower risk of diabetes preceded by beta-cell dysfunction.
For older adults, high body weight and low HDL cholesterol are strong predictors for developing diabetes driven by insulin resistance, but may actually be associated with a lower risk of diabetes driven by beta-cell failure. This suggests that metabolic subtyping is important for risk assessment in the elderly.
obesity and lower high-density lipoprotein cholesterol levels were positively associated with DM preceded predominantly by IR (hazard ratio (HR) = 5.02, 95% confidence interval (CI): 2.81, 9.00; and HR = 1.97, 95% CI: 1.32, 2.93, respectively), with a significant association with and an insignificant trend toward a lower risk of DM preceded predominantly by β-cell dysfunction (HR = 0.33, 95% CI: 0.14, 0.80; and HR = 0.78, 95% CI: 0.43, 1.39, respectively).
Why this rating
Large prospective cohort (n=4,384), long follow-up (median 11.7 years), multivariable adjusted.
Source
Risk Factors for Type 2 Diabetes Mellitus Preceded by β-Cell Dysfunction, Insulin Resistance, or Both in Older Adults
Fumiaki Imamura et al. · American Journal of Epidemiology · 2013
DOI 10.1093/aje/kws440
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