Serial Metabolic Measurements and Conversion to Type 2 Diabetes in the West of Scotland Coronary Prevention Study
Open Access
- 1 April 2007
- journal article
- Published by American Diabetes Association in Diabetes
- Vol. 56 (4), 984-991
- https://doi.org/10.2337/db06-1256
Abstract
To examine metabolic changes (lipids, liver enzymes, blood pressure, and weight) potentially associated with conversion to diabetes, we analyzed serial glucose and other metabolic measures obtained every 6 months within the West of Scotland Coronary Prevention Study trial. Changes in parameters for 86 men who converted to new-onset diabetes (“converters”: two consecutive glucose levels ≥7 mmol/l) were compared with 860 “nonconverters” matched for age and treatment allocation. Eighteen months before the diagnosis, converters to diabetes had elevated (P < 0.01) fasting glucose, weight, triglyceride, alanine aminotransferase (ALT), blood pressure, and white cell count and lower HDL cholesterol compared with nonconverters. The mean (SD) increase in fasting glucose over 18 months in converters was 1.80 (1.52) mmol/l, compared with 0.10 (0.57) in nonconverters. Of parameters measured, only ALT (P = 0.0005) and triglyceride (P = 0.030) increased significantly more over the 18 months in converters compared with nonconverters, but neither parameter increased significantly in nonconverters with high baseline glucose concentrations (>6.1 mmol/l). Finally, only sustained increases in ALT predicted a higher risk for diabetes. We conclude that a relatively rapid rise in fasting glucose levels is frequent in converters to diabetes and that associated increases over time in ALT and potentially triglyceride suggest hepatic fat accumulation as a contributing factor for conversion to diabetes in men at risk.Keywords
This publication has 29 references indexed in Scilit:
- Alanine aminotransferase as a marker of non‐alcoholic fatty liver disease in relation to type 2 diabetes mellitus and cardiovascular diseaseDiabetes/Metabolism Research and Reviews, 2006
- Predictors of and Longitudinal Changes in Insulin Sensitivity and Secretion Preceding Onset of Type 2 DiabetesDiabetes, 2005
- Elevated Alanine Aminotransferase Predicts New-Onset Type 2 Diabetes Independently of Classical Risk Factors, Metabolic Syndrome, and C-Reactive Protein in the West of Scotland Coronary Prevention StudyDiabetes, 2004
- Elevations in Markers of Liver Injury and Risk of Type 2 DiabetesDiabetes, 2004
- Mode of Onset of Type 2 Diabetes from Normal or Impaired Glucose ToleranceDiabetes, 2004
- Metabolic Syndrome With and Without C-Reactive Protein as a Predictor of Coronary Heart Disease and Diabetes in the West of Scotland Coronary Prevention StudyCirculation, 2003
- High Alanine Aminotransferase Is Associated With Decreased Hepatic Insulin Sensitivity and Predicts the Development of Type 2 DiabetesDiabetes, 2002
- C-Reactive Protein Is an Independent Predictor of Risk for the Development of Diabetes in the West of Scotland Coronary Prevention StudyDiabetes, 2002
- Prevention of Coronary Heart Disease with Pravastatin in Men with HypercholesterolemiaThe New England Journal of Medicine, 1995
- DIABETES INCIDENCE IN PIMA INDIANS: CONTRIBUTIONS OF OBESITY AND PARENTAL DIABETES1American Journal of Epidemiology, 1981