Family History of Diabetes and the Effectiveness of Lifestyle Intervention on Insulin Secretion and Insulin Resistance in Chinese Individuals with Metabolic Syndrome

Abstract

Aims. The current study aims to explore if a family history of diabetes can influence the efficiency of lifestyle intervention on insulin secretion and study the insulin resistance in Chinese men and women with metabolic syndrome in a cohort with a 2-year follow-up. Methods. 151 individuals (90 individuals did not have a family history of diabetes (DMFH (-)) and 61 with a family history of diabetes (DMFH (+)) with metabolic syndrome participated in the lifestyle intervention program at baseline and finished with 1-year follow-up. 124 individuals have two-year follow-up data. A family history of diabetes was ascertained by self-report. Lifestyle interventions were individual sessions on lifestyle changes. Results. During the 1-year follow-up, Ln Insulinogenic index ( ${\Delta }_{\text{baseline}-1\text{year}}=0.29\pm 0.65$ , $P=0.001$ ) and 30-min glucose ( ${\Delta }_{\text{baseline}-1\text{year}}=-0.41\pm 1.71$ , $P=0.024$ ) changed significantly in the DMFH(-) group; in the DMFH(+) group, Ln ISIm ( ${\Delta }_{\text{baseline}-1\text{year}}=-0.22\pm 0.60$ , $P=0.022$ ) and 30-min glucose ( ${\Delta }_{\text{baseline}-1\text{year}}=0.53\pm 1.89$ , $P=0.032$ ) changed significantly, and there was no significant change of other parameters. The change of 30 min glucose during a 1-year intervention has shown a significant difference between the two groups ( $P=0.002$ ). During the 2 years intervention, Ln Insulinogenic index changed significantly in the DMFH(-) group ( ${\Delta }_{\text{baseline}-1\text{year}}=0.33\pm 0.66$ , $P<0.001$ and ${\Delta }_{\text{baseline}-2\text{year}}=0.43\pm 1.17$ , $P=0.034$ ). Fasting insulin ( ${\Delta }_{\text{baseline}-2\text{year}}=2.95\pm 8.69$ , $P=0.034$ ), 2 h insulin ( ${\Delta }_{\text{baseline}-2\text{year}}=23.75\pm 44.89$ , $P=0.002$ ), Ln HOMA-B ( ${\Delta }_{\text{baseline}-2\text{year}}=0.43\pm 1.02$ , $P=0.009$ ), Ln HOMA-IR ( ${\Delta }_{\text{baseline}-2\text{year}}=0.53\pm 1.04$ , $P=0.002$ ), Ln ISIm ( ${\Delta }_{\text{baseline}-2\text{year}}=0.52\pm 0.95$ , $P=0.004$ ), and Ln Insulinogenic index ( ${\Delta }_{\text{baseline}-2\text{year}}=0.66\pm 1.18$ , $P=0.047$ ) changed significantly after 2 years of intervention, compared to the baseline in the DMFH(+) group. The change of Ln ISIm ( $P=0.023$ ), fasting ( $P=0.030$ ), and 2 h insulin ( $P=0.007$ ) during the 2-year intervention has shown a significant difference between the two groups. Family history of diabetes was related with a 0.500 unit increase in 2-year ISIm ( $P=0.020$ ) modified by lifestyle intervention adjusted for age, baseline BMI, sex, and baseline waist circumference and a 0.476 unit increase in 2-year ISIm ( $P=0.027$ ) with extra adjustment for weight change. Conclusions. Patients with a family history of diabetes benefit more from lifestyle intervention in regard to insulin resistance than those without a family history of diabetes adjusting for age, baseline BMI, sex, baseline waist circumference, and weight change.