RT Journal Article
T1 Beta cell functionality and hepatic insulin resistance are major contributors to type 2 diabetes remission and starting pharmacological therapy: from CORDIOPREV randomized controlled trial.
A1 Roncero-Ramos, Irene
A1 Gutierrez-Mariscal, Francisco M
A1 Gomez-Delgado, Francisco
A1 Villasanta-Gonzalez, Alejandro
A1 Torres-Peña, Jose D
A1 Cruz-Ares, Silvia De La
A1 Rangel-Zuñiga, Oriol A
A1 Luque, Raul M
A1 Ordovas, Jose M
A1 Delgado-Lista, Javier
A1 Perez-Martinez, Pablo
A1 Camargo, Antonio
A1 Alcalá-Diaz, Juan F
A1 Lopez-Miranda, Jose
K1 ALT = alanine aminotransferase
K1 AUC = area under curve
K1 Adipo-IR = Adipose tissue insulin resistance index
K1 BMI = body mass index
K1 CHD = coronary heart disease
K1 CORDIOPREV = CORonary Diet Intervention with Olive oil and cardiovascular PREVention
K1 DBP = diastolic blood pressure
K1 DI = disposition index
K1 FFA = free fatty acids
K1 HDL-c = high-density lipoprotein
K1 Hepatic-IR(fasting) = hepatic insulin resistance index derived from fasting values
K1 IGI = insulinogenic index
K1 IR = insulin resistance
K1 ISI = insulin sensitivity index
K1 LDL-c = low-density lipoprotein
K1 LF diet = low-fat diet
K1 MISI = muscular insulin sensitivity index
K1 MUFA = monounsaturated fatty acids
K1 Med diet = Mediterranean diet
K1 OGTT = oral glucose tolerance test
K1 PUFA = polyunsaturated fatty acids
K1 SBP = systolic blood pressure
K1 T2DM = type 2 diabetes mellitus
K1 TG = triglycerides
AB In order to assess whether previous hepatic IR (Hepatic-IRfasting) and beta-cell functionality could modulate type 2 diabetes remission and the need for starting glucose-lowering treatment, newly-diagnosed type 2 diabetes participants who had never received glucose-lowering treatment (190 out of 1002) from the CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (a prospective, randomized and controlled clinical trial), were randomized to consume a Mediterranean or a low-fat diet. Type 2 diabetes remission was defined according to the American Diabetes Association recommendation for levels of HbA1c, fasting plasma glucose and 2h plasma glucose after oral glucose tolerance test, and having maintained them for at least 2 consecutive years. Patients were classified according to the median of Hepatic-IRfasting and beta-cell functionality, measured as the disposition index (DI) at baseline. Cox proportional hazards regression determined the potential for Hepatic-IRfasting and DI indexes as predictors of diabetes remission and the probability of starting pharmacological treatment after a 5-year follow-up. Low-Hepatic-IRfasting or high-DI patients had a higher probability of diabetes remission than high-Hepatic-IRfasting or low-DI subjects (HR:1.79; 95% CI 1.06-3.05; and HR:2.66; 95% CI 1.60-4.43, respectively) after a dietary intervention with no pharmacological treatment and no weight loss. The combination of low-Hepatic-IRfasting and high-DI presented the highest probability of remission (HR:4.63; 95% CI 2.00-10.70). Among patients maintaining diabetes, those with high- Hepatic-IRfasting and low-DI showed the highest risk of starting glucose-lowering therapy (HR:3.24;95% CI 1.50-7.02). Newly-diagnosed type 2 diabetes patients with better beta-cell functionality and lower Hepatic-IRfasting had a higher probability of type 2 diabetes remission in a dietary intervention without pharmacological treatment or weight loss, whereas among patients not achieving remission, those with worse beta-cell functionality and higher Hepatic-IRfasting index had the highest risk of starting glucose-lowering treatment after 5 years of follow-up.
YR 2021
FD 2021-07-21
LK https://hdl.handle.net/10668/24452
UL https://hdl.handle.net/10668/24452
LA en
DS RISalud
RD Apr 15, 2025