Serum insulin, insulin resistance, p-cell dysfunction, and gallstone disease among type 2 diabetics in Chinese population: A community-based study in Kinmen, Taiwan  

作　　者：Chi-Ming Liu Tao-Hsin Tung Shih-Tzer Tsai Jorn-Hon Liu Yeh-Kuang Tsai Victor Tze-Kai Chen Tseng-Nip Tam Hsu-Feng Lu Kuang-Kuo Wang Chung-Te Hsu Hui-Chuan Shih De-Chuan Chan Pesus Chou 

机构地区：[1]Community Medicine Research Center and Institute of Public Health, National Yang-MingUniversity, Cheng Hsin General Hospital, Taipei, Taiwan, China [2]Department of medicine, Veterans GeneralHospital, Taipei, Taiwan, China [3]Cheng Hsin General Hospital, Faculty ofMedicine, School of Medicine, National Yang-Ming University,Taipei, Taiwan, China [4]University of California San Francisco, SanFrancisco, CA, United States [5]Cardinal Tien Hospital, College ofMedicine, Fu-Jen Catholic University, National Defence MedicineCenter, Taipei, Taiwan, China [6]Cheng Hsin General Hospital, Taipei, Taiwan, China [7]Department of Nursing, Kaohsiung MilitaryGeneral Hospital, Kaohsing, Taipei, Taiwan, China [8]Division of General Surgery, Tri-ServiceGeneral Hospital, National Defence Medical Center, Taipei,Taiwan, China [9]Community Medicine Research Center and Instituteof Public Health, National Yang-Ming University, Taipei, Taiwan,China

出　　处：《World Journal of Gastroenterology》2005年第45期7159-7164,共6页世界胃肠病学杂志（英文版）

基　　金：Supported by the grants from the National Science Council, Nos.NSC-91-2320-B-010-102 and NSC-92-2320-B-010-102

摘　　要：AIM: To explore the association of serum insulin, insulin resistance, and β-cell dysfunction with gallstone disease (GSD) in type 2 diabetics. METHODS: We used a community-based study conducted between 1991 and 1993 in Kinmen, Taiwan to identify type 2 diabetics. A screening program for GSD was performed in 2001 by a panel of specialists who employed real-time ultrasound sonography to examine the abdominal region after the patient had fasted for at least 8 h. Screening was conducted in 2001 on 848 patients diagnosed with type 2 diabetes. The HOMA method was used to compare the profile differences for insulin resistance (HOMA IR) and β-cell dysfunction (HOMA β-cell). RESULTS: We studied 440 type 2 diabetics who attended sonography check-ups. After excluding eight insulin-treated diabetics, the prevalence of GSD among the remaining 432 was 13.9% (26/187) among males and 14.7% (36/245) among females. After adjustment for other GSD-associated risk factors in addition to age and obesity, GSD risk increased among females with levels of serum insulin [4th vs 1st quartile odds ratios (OR) = 4.46 (95%CI: 1.71-11.66)] and HOMA IR [4th vs 1st quartile OR = 4.46 (95%CI: 1.71-11.66)]. Better HOMA β-cell function was significantly related to decreased risk of GSD [4th vs 1st quartile OR = 0.16 (95%CI: 0.03-1.70)]. Among males, age and central obesity were the most significant risk factors for GSD. No association of GSD with serum insulin, HOMA IR, and HOMA β-cell was observed among males. CONCLUSION: Serum insulin, insulin resistance, and β-cell dysfunction are risk factors for GSD in females, but not males with type 2 diabetes.AIM： To explore the association of serum insulin, insulin resistance, and β-cell dysfunction with gallstone disease （GSD） in type 2 diabetics. METHODS： We used a community-based study conducted between 1991 and 1993 in Kinmen, Taiwan to identify type 2 diabetics. A screening program for GSD was performed in 2001 by a panel of specialists who employed real-time ultrasound sonography to examine the abdominal region after the patient had fasted for at least 8 h. Screening was conducted in 2001 on 848 patients diagnosed with type 2 diabetes. The HOMA method was used to compare the profile differences for insulin resistance （HOMA IR） and β-cell dysfunction （HOMA β-cell）.RESULTS： We studied 440 type 2 diabetics who attended sonography check-ups. After excluding eight insulin-treated diabetics, the prevalence of GSD among the remaining 432 was 13.9% （26/187） among males and 14.7% （36/245） among females. After adjustment for other GSD-associated risk factors in addition to age and obesity, GSD risk increased among females with levels of serum insulin [4th VS 1st quartile odds ratios （OR） = 4.46 （95%CI： 1.71-11.66）] and HOMA IR [4th vs 1st quartile OR = 4.46 （95%CI： 1.71-11.66）]. Better HOMA β-cell function was significantly related to decreased risk of GSD [4th vs 1st quartile OR = 0.16 （95%CI： 0.03-1.70）]. Among males, age and central obesity were the most significant risk factors for GSD. No association of GSD with serum insulin, HOMA IR, and HOMA β-cell was observed among males. CONCLUSION： Serum insulin, insulin resistance, and β-cell dysfunction are risk factors for GSD in females, but not males with type 2 diabetes.

关 键 词：Type 2 diabetes Gallstone disease INSULINRESISTANCE β-cell dysfunction Community-based study 

分 类 号：R587.1[医药卫生—内分泌]