The Japanese-American population of King County, Washington, is known to have a high prevalence of non-insulin-dependent diabetes mellitus (NIDDM). As part of a community-based study, we reexamined 146 second-generation Japanese-American men who had been initially classified as nondiabetic. At a mean follow-up period of 30 mo, 15 men had developed NIDDM, and 131 remained nondiabetic. The variables measured at the initial visit that distinguished the 15 diabetic men from the 131 nondiabetic men were older age, higher serum glucose level at 2 h after 75 g oral glucose, higher fasting plasma C-peptide level, and increased cross-sectional intra-abdominal fat area as determined by computed tomography. Both older age and higher 2-h glucose levels are variables that have been associated with the development of NIDDM, but the association of higher fasting C-peptide level and greater intra-abdominal fat area with subsequent development of NIDDM were new observations. The elevated fasting C-peptide level persisted after adjustment for fasting serum glucose. The elevated C-peptide level represents hypersecretion of insulin and was interpreted to reflect a compensatory response to an underlying insulin-resistant state that antedates the development of NIDDM. The fasting C-peptide level was correlated with the intra-abdominal fat area, suggesting that the intra-abdominal fat area may be associated with insulin resistance. Thus, in individuals who develop NIDDM, insulin resistance, increased insulin secretion, and increased intra-abdominal fat are present before diabetic glucose tolerance can be demonstrated.
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Original Articles|
January 01 1990
Association of Elevated Fasting C-Peptide Level and Increased Intra-Abdominal Fat Distribution With Development of NIDDM in Japanese-American Men
Richard W Bergstrom;
Richard W Bergstrom
Departments of Medicine, Radiology, Anthropology, and Biostatistics, the University of Washington
Seattle, Washington
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Laura L Newell-Morris;
Laura L Newell-Morris
Departments of Medicine, Radiology, Anthropology, and Biostatistics, the University of Washington
Seattle, Washington
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Donna L Leonetti;
Donna L Leonetti
Departments of Medicine, Radiology, Anthropology, and Biostatistics, the University of Washington
Seattle, Washington
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William P Shuman;
William P Shuman
Departments of Medicine, Radiology, Anthropology, and Biostatistics, the University of Washington
Seattle, Washington
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Patricia W Wahl;
Patricia W Wahl
Departments of Medicine, Radiology, Anthropology, and Biostatistics, the University of Washington
Seattle, Washington
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Wilfred Y Fujimoto
Wilfred Y Fujimoto
Departments of Medicine, Radiology, Anthropology, and Biostatistics, the University of Washington
Seattle, Washington
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Address correspondence and reprint requests to Dr. Wilfred Y. Fujimoto, Department of Medicine, Division of Metabolism, Endocrinology, and Nutrition, RG-26, University of Washington, Seattle, WA 98195.
Diabetes 1990;39(1):104–111
Article history
Received:
April 25 1989
Revision Received:
September 12 1989
Accepted:
September 12 1989
PubMed:
2210052
Citation
Richard W Bergstrom, Laura L Newell-Morris, Donna L Leonetti, William P Shuman, Patricia W Wahl, Wilfred Y Fujimoto; Association of Elevated Fasting C-Peptide Level and Increased Intra-Abdominal Fat Distribution With Development of NIDDM in Japanese-American Men. Diabetes 1 January 1990; 39 (1): 104–111. https://doi.org/10.2337/diacare.39.1.104
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