BES2005 Oral Communications Oral Communication 1: Diabetes and metabolism (9 abstracts)
The relationship of beta-cell function with age: effect of population migration
AH Heald 1 , SG Anderson 2 , J Patel 3 , A Rudenski 4 , A Vyas 2,5 , I Laing 6 , E Hughes 3 , D Prabharakan 2 , P Durrington 5 & JM Gibson 1
1Department of Diabetes & Endocrinology, Salford NHS Trust, Salford, UK; 2Clinical Epidemiology Group, University of Manchester, UK; 3Department of Clinical Biochemistry, Sandwell General Hospital, Birmingham, UK; 4Department of Clinical Biochemistry, Salford Royal Hospitals NHS Trust, Salford, UK; 5University Department of Medicine, Manchester Royal Infirmary, Manchester, UK; 6Department of Clinical Biochemistry, Manchester Royal Infirmary, Manchester, UK.
Aims
The increasing incidence of type 2 diabetes mellitus with age in the context of ageing populations worldwide highlights the need to understand better factors that influence glucose homeostasis. Our hypothesis was that lifestyle change accompanying migration influences the relationship between pancreatic beta cell function (HOMA-B) and age.
Methods
We compared a specific migrant Gujarati community in Britain (n=205) with people still resident in the same villages of origin in India (n=246). HOMA-B was determined and the influence of age, migration and other factors was explored.
Results
In both groups there was an age related decline in HOMA-B. The age related fall in HOMA-B was markedly steeper in the UK (Spearman's rho = -0.28, p<0.001) than in Gujarat (rho =-0.16, p=0.01), p for difference = 0.03. The decline of HOMA-B with age persisted after adjustment for BMI (Gujarat: normalised beta = -0.16, p=0.015; UK: normalised beta = -0.31, p<0.001). There was no significant change in insulin sensitivity (HOMA-S) with age at either site, although insulin sensitivity was lower in UK. Fasting NEFA levels rose with age in the UK but not in Gujarat (p=0.003 for difference in gradients).
In multiple linear regression analysis lower HOMA-B was independently and significantly associated with higher fasting NEFA levels; normalised beta =-0.23, p<0.001, age; beta = -0.17, p=0.003, higher lnIGFBP-1; beta = -0.119, p=0.006 and lower BMI; beta = 0.22, p=0.003. This model, which also included ln IGF-I, IGFBP-3, lnCRP, gender and migrant status accounted for 25% of the variability in HOMA-B.
Conclusions
HOMA-B as a measure of beta-cell function declines more rapidly with age in the migrant UK group than in Gujarat. This may be a direct consequence of chronically higher NEFA exposure in the UK group. The lower BMI and higher IGFBP-1 associated with lower HOMA-B indicate declining insulin secretion and hepatic insulin action in the context of failing body weight regulation with age.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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