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Risk factors for incident type 2 diabetes in individuals with a BMI of <27 kg/m2: the role of gamma-glutamyltransferase. Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR).
Gautier A., Balkau B., Lange C., Tichet J., Bonnet F.,
Diabetologia 53, 2 (2010) 247-53 - http://hal.archives-ouvertes.fr/hal-00659553
Sciences du Vivant/Médecine humaine et pathologie/Endocrinologie et métabolisme
(19936701)
Risk factors for incident type 2 diabetes in individuals with a BMI of <27 kg/m2: the role of gamma-glutamyltransferase. Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR).
Alain Gautier1, Beverley Balkau2, Céline Lange2, 3, Jean Tichet4, Fabrice Bonnet1, 5,
1 :  Foie, métabolismes et cancer
http://insermu991.univ-rennes1.fr
INSERM : U991 – Université de Rennes 1 – Biosit
Hôpital Pontchaillou Rue Henri Le Guilloux 35033 Rennes Cedex
France
2 :  Recherche en épidémiologie et biostatistique
INSERM : IFR69 – Université Paris XI - Paris Sud
16, Avenue Paul Vaillant-Couturier 94807 VILLEJUIF CEDEX
France
3 :  CESP - Centre de recherche en épidémiologie et santé des populations
INSERM : U1018 – Université Paris XI - Paris Sud – Hôpital Paul Brousse – Assistance publique - Hôpitaux de Paris (AP-HP)
16 avenue Paul Vaillant Couturier 94807 Villejuif Cedex, France
France
4 :  IRSA - Institut inter Régional pour la SAnté
Centre de Prévention et de Santé Publique de Tours - La Riche
45 rue de la Parmentière 37 521 La Riche Cedex
France
5 :  GERHM - Groupe d'Etude de la Reproduction Chez l'Homme et les Mammiferes
INSERM : U625 – Université de Rennes 1 – IFR140 – IRSET
263, Avenue du Général Leclerc 35042 Rennes Cedex
France
Recherches Epidémiologiques sur l'Environnement et la Reproduction
AIMS/HYPOTHESIS: Risk factors for incident type 2 diabetes, in particular, hepatic markers, have rarely been studied in leaner individuals. We aimed to identify the metabolic and hepatic markers associated with incident diabetes in men and women with a BMI of <27 kg/m(2) and to compare them with those in individuals with a BMI of >or=27 kg/m(2). METHODS: Risk factors for 9 year incident diabetes were compared in the French Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort. Comparisons were made between the 2,947 participants with a BMI of <27 kg/m(2) and the 879 with a BMI of >or=27 kg/m(2). RESULTS: There were 92 incident cases of diabetes in individuals with a BMI of <27 kg/m(2) and 111 in those with a BMI of >or=27 kg/m(2). Among those who were not markedly overweight, classical biological markers were associated with 9 year incident diabetes, glycaemia being the strongest predictor. gamma-Glutamyltransferase (GGT), either considered as a continuous variable or at levels >or=20 U/l, was associated with incident diabetes, with a stronger effect in the BMI <27 kg/m(2) group: OR 1.59 (95% CI 1.29-1.97, p < 0.001) in comparison with OR 1.07 (95% CI 0.82-1.38, p = 0.63) for those with a BMI of >or=27 kg/m(2) (results after adjustment for alcohol intake, alanine aminotransferase, waist circumference and the HOMA insulin resistance index). CONCLUSIONS/INTERPRETATION: In individuals with a BMI of <27 kg/m(2), GGT was the strongest predictor of diabetes after fasting hyperglycaemia. This association with incident diabetes remained after adjustment for conventional markers of insulin resistance, suggesting potential interactions between GGT, enhanced hepatic neoglucogenesis and/or early alterations of insulin secretion.
Anglais

Articles dans des revues avec comité de lecture
10.1007/s00125-009-1602-6
Diabetologia (Diabetologia)
Publisher Springer Verlag (Germany)
ISSN 0012-186X (eISSN : 1432-0428)
internationale
02/2010
20/11/2009
53
2
247-53

BMI – Diabetes – γ-glutamyltransferase – Liver – Risk factors
Adult – Blood Glucose – Body Mass Index – Diabetes Mellitus – Type 2 – Exercise – Fasting – Female – Follow-Up Studies – France – Humans – Incidence – Insulin – Insulin Resistance – Male – Middle Aged – Overweight – Risk Factors – Waist Circumference – Weight Gain – gamma-Glutamyltransferase