Evaluation of insulin sensitivity and pancreatic secretion function in young and elderly individuals using the oral minimal model method and its influencing factors
Objective To evaluate insulin sensitivity(IS)and pancreatic β-cell secretion function in the elderly,analyze the influencing factors,and compare these parameters with those observed in adults.Methods A total of 301 participants were selected from the health examination population at the Geriatrics Endocrinology Department of Jiangsu Provincial People's Hospital,all of whom had no history of diabetes,between December 2018 and June 2021.Participants were categorized into elderly and adult groups based on age.Personal and medical histories were recorded,and various measurements,including height,weight,waist circumference,hip circumference,blood lipids,and nutritional metabolic indicators,were obtained.Body composition was assessed using dual-emission X-ray absorptiometry(DXA).The oral minimal model(OMM)method was utilized to derive the insulin sensitivity index(ISI),dynamic insulin secretion(Φd),static insulin secretion(Φs),total insulin secretion(Φt),and disposition index(DI).Participants were grouped according to the results of oral glucose tolerance tests.Finally,the factors influencing IS and pancreatic β-cell function were analyzed in both elderly and adult populations,as well as to identify any differences between the two groups.Results Following adjustments for gender and body mass index(BMI),partial correlation analysis indicated a decrease in Φd,DI-Φd,and DI-Φt with advancing age(r=-0.219,-0.210,-0.187;P=0.005,0.015,0.017).In contrast,ISI,Φs,Φt,and DI-Φs showed no significant correlation with age.Although ISI levels were comparable between the elderly and adult groups,individuals newly diagnosed with diabetes in the elderly cohort exhibited higher DI-Φd,DI-Φs,and DI-Φt compared to those in the adult group after ISI correction.When incorporating age,high-density lipoprotein cholesterol(HDL-C),total muscle mass,the android to gynoid ratio(A/G),and fat mass index(FMI)into a binary Logistic regression model,the findings underscored FMI as a common risk factor for both elderly and adult cohorts concerning the ISI(OR=2.324,1.773;P=0.032,0.005).The A/G ratio was identified as a risk factor for DI-Φd in both age groups(OR=69 252.464,407.653;P=0.012,0.001).Furthermore,HDL-C was recognized as a protective factor for ISI(OR=0.024,P=0.012)in the elderly,while advancing age(OR=1.454,P=0.039)was found to be a risk factor for DI-Φs in this demographic.Total muscle mass and the A/G ratio were also acknowledged as risk factors for ISI(OR=1.054,15.725;P=0.021,0.026),with FMI serving as a risk factor for DI-Φs in the adult cohort(OR=1.826,P=0.035).Conclusions The secretion function of pancreatic β-cells declines with age,whereas ISI remains unchanged.The factors affecting ISI,DI-Φd,and DI-Φs in elderly and adult populations show notable differences.This indicates that implementing targeted lifestyle interventions for distinct age groups may be more effective in preserving both ISI and pancreatic β-cell function.
Diabetes mellitusInsulinInfluencing factorOral minimal model
万方数据
维普
