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HOME > Kosin Med J > Volume 31(2); 2016 > Article
Original Article
Obesity and Insulin Resistance According to Age in Newly Diagnosed Type 2 Diabetes Patients in Korea
Ju Won Lee, Nam Kyu Kim, Hyun Joon Park, Jun Yeob Lee, Seon Yoon Choi, Eun Mi Lee, So Young Ock, Su Kyoung Kwon, Young Sik Choi, Bu Kyung Kim
Kosin Medical Journal 2016;31(2):157-166.
DOI: https://doi.org/10.7180/kmj.2016.31.2.157
Published online: January 20, 2016

Department of Internal Medicine, College of Medicine, Kosin University, Korea

Corresponding Author: Bu Kyung Kim, Department of Internal Medicine Devision of Endocrinology and Metabolism, College of Medicine, Kosin University, 262, Gamcheon-ro, Seo-gu, Busan 49267, Korea Tel: +82-51-990-6532 Fax: +82-51-990-3065 E-mail: 79kyung@hanmail.net
• Received: June 3, 2015   • Accepted: December 10, 2015

Copyright © 2016 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    With the rapid increase in the prevalence of diabetes, the age groups of diabetic patients are becoming diversified. This study will examine the degree of obesity, insulin resistance, and insulin secretion ability among patients first diagnosed with diabetes according to age and gender.
  • Methods
    The subjects of this study included 616 patients who were first diagnosed with diabetes during a routine physical examination. This sample was obtained from a total of 28,075 adults aged 19 years and older who received the examination among 33,829 participants in the Korea National Health & Nutrition Examination Survey (KNHANES) from 2007–2010. The subjects were categorized by age into young age (age: 19 – 39 years), middle age (age: 40 – 59 years), and old age (age: 60 years and older). The degree of obesity was categorized according to body mass index (BMI) into normal weight (BMI: 18.5 ∼ 22.9), overweight (BMI: 23 ∼ 24.9), and obesity (BMI: 25 or above). Insulin resistance was evaluated by homeostatic model assessment of insulin resistance (HOMA-IR).
  • Results
    It was found that 14.1% (n = 87) of a total of 616 subjects (324 men, 292 women) were in the young age group, 43.8% (n = 270) were in the middle age group, and 42.1% (n = 259) were in the old age group. In addition, 83.3% of men that were overweight or obesity were in the young age group, while 79.2% and 60.5% were in the middle age and old age groups, respectively. A total of 82.2% of women that were overweight or obesity were in the young age group, while 79.5% and 77% were in the middle age and old age groups, respectively. For men, the more obesity they were in all age groups, the higher their HOMA-IR. For women, the more obesity they were in the young age and middle age groups, the higher their HOMA-IR; however, women in the old age group showed the highest HOMA-IR when they were of normal weight.
  • Conclusion
    Among diabetic patients first diagnosed with the disease in Korea, the youth population had the highest obesity rate. Insulin resistance increases as an individual's weight increases among those patients who are first diagnosed with diabetes; the only exception noted is for elderly women.
  • Keywords: Diabetes; degree of obesity; insulin resistance
Fig. 1.
Obesity according to age group in male and female.
kmj-31-157f1.jpg
Fig. 2.
HOMA-IR according to age group in male.
kmj-31-157f2.jpg
Fig. 3.
HOMA-IR according to age group in female.
kmj-31-157f3.jpg
Fig. 4.
Relationship between insulin resistance and insulin secretory function according to obesity and age group in male. Y-N: young normal, Y-OW: young overweight, Y-O: young obesity M-N: middle normal, M-OW: middle overweight, M-O: middle obesity O-N: old normal, O-OW: old overweight, O-O: old obesity
kmj-31-157f4.jpg
Fig. 5.
Relationship between insulin resistance and insulin secretory function according to obesity and age group in female. Y-N: young normal, Y-OW: young overweight, Y-O: young obesity M-N: middle normal, M-OW: middle overweight, M-O: middle obesity O-N: old normal, O-OW: old overweight, O-O: old obesity
kmj-31-157f5.jpg
Table 1.
Baseline characteristics according to age group
  Young age 19 ∼ 39 yrs (n = 87, 14.1%) Middle age 40 ∼ 59 yrs (n = 270, 43.8%) Old age 60 ∼ yrs (n = 259, 42.1%) P- value
Age (yr) 35.06 ± 3.92 50.34 ± 5.64 70.13 ± 6.64 0.000 a,b,c
Height (cm) 164.72 ± 9.36 163.47 ± 8.32 157.75 ± 9.49 0.000 b,c
Weight (Kg) 73.09 ± 14.47 68.65 ± 11.58 61.35 ± 10.29 0.000 a,b,c
AC (cm) 88.11 ± 11.38 87.31 ± 8.87 86.90 ± 9.47 0.590
BMI (kg/㎡) 26.89 ± 4.70 25.59 ± 3.25 24.60 ± 3.30 0.000 a,b,c
FBS (mg/dL) 145.4 ± 56.65 153.53 ± 42.52 139.64 ± 35.29 0.001 c
HbA1c (%A1c) 7.20 ± 2.02 7.38 ± 1.74 6.95 ± 1.33 0.015 c
Systolic BP (mmHg) 119.03 ± 16.54 125.81 ± 16.61 133.23 ± 18.84 0.000 a,b,c
Diastolic BP (mmHg) 80.60 ± 12.96 83.15 ± 10.09 77.85 ± 10.34 0.000 c
Total cholesterol (mg/dL) 202.14 ± 33.73 205.70 ± 38.87 199.18 ± 41.04 0.162
HDL (mg/dL) 47.55 ± 10.51 47.71 ± 11.44 47.47 ± 12.38 0.972
Triglyceride (mg/dL) 188.5 ± 147.82 213.12 ± 167.75 172.91 ± 132.78 0.009 c
HOMA-IR 5.00 ± 4.05 4.70 ± 3.53 4.89 ± 4.71 0.797
HOMA β-cell 87.94 ± 77.40 58.13 ± 40.92 70.67 ± 47.05 0.000 a,b,c

Data are mean ± standard deviation. AC, abdominal circumference; FBS, fasting plasma sugar; HbA1C, hemoglobin A1c; HOMA-IR, [Fasting insulin (IU/mL) × fasting plasma glucose (mmol/L)] / 22.5; HOMA β-cell, [20 × fasting plasma insulin (IU/mL)] / [fasting plasma glucose (mmol/L) – 3.5]; a, young age group and middle age group, P< 0.05; b, young age group and old age group, P< 0.05; c, middle age group and old age group, P< 0.05

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      Obesity and Insulin Resistance According to Age in Newly Diagnosed Type 2 Diabetes Patients in Korea
      Kosin Med J. 2016;31(2):157-166.   Published online January 20, 2016
      DOI: https://doi.org/10.7180/kmj.2016.31.2.157
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