Individuals With Prediabetes Display Different Age-Related Pathophysiological Characteristics

Area of Science:

• Endocrinology
• Metabolic Health
• Gerontology

Background:

• Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are heterogeneous prediabetes conditions.
• These conditions affect all age groups, from youth to the elderly.
• Distinct age-related pathophysiological characteristics may exist within IFG and IGT groups.

Purpose of the Study:

• To investigate age-related phenotypic differences in individuals with IFG or IGT.
• To compare insulin sensitivity, secretion, and β-cell function across different age groups with prediabetes.

Main Methods:

• Oral glucose tolerance test (OGTT) performed on 479 young, 699 adult, and 240 older subjects.
• Participants categorized into normal glucose tolerance (NGT), IFG, and IGT groups based on age.
• Assessment of insulin sensitivity (Matsuda index), insulin secretion, insulin clearance, and β-cell function (disposition index).

Main Results:

• IFG in adults and older individuals showed decreased peripheral insulin sensitivity and β-cell function compared to young IFG subjects.
• Individuals with IGT exhibited age-related differences in hepatic insulin resistance and insulin clearance.
• Insulin secretion and β-cell function were reduced in adult and older IGT subjects compared to young IGT individuals.

Conclusions:

• IFG and IGT present with distinct age-related pathophysiological profiles.
• Precise phenotyping of prediabetes based on age is crucial.
• Individualized preventive strategies can be developed to mitigate diabetes progression based on these findings.