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World J Gastroenterol. Dec 7, 2005; 11(45): 7159-7164
Published online Dec 7, 2005. doi: 10.3748/wjg.v11.i45.7159
Serum insulin, insulin resistance, β-cell dysfunction, and gallstone disease among type 2 diabetics in Chinese population: A community-based study in Kinmen, Taiwan
Chi-Ming Liu, Tao-Hsin Tung, Shih-Tzer Tsai, Jorn-Hon Liu, Yeh-Kuang Tsai, Victor Tze-Kai Chen, Tseng-Nip Tam, Hsu-Feng Lu, Kuang-Kuo Wang, Chung-Te Hsu, Hui-Chuan Shih, De-Chuan Chan, Pesus Chou
Chi-Ming Liu, Tao-Hsin Tung, Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Cheng Hsin General Hospital, Taipei, Taiwan, China
Shih-Tzer Tsai, Department of medicine, Veterans General Hospital, Taipei, Taiwan, China
Jorn-Hon Liu, Cheng Hsin General Hospital, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, China
Yeh-Kuang Tsai, University of California San Francisco, San Francisco, CA, United States
Victor Tze-Kai Chen, Cardinal Tien Hospital, College of Medicine, Fu-Jen Catholic University, National Defence Medicine Center, Taipei, Taiwan, China
Tseng-Nip Tam, Hsu-Feng Lu, Kuang-Kuo Wang, Chung-Te Hsu, Cheng Hsin General Hospital, Taipei, Taiwan, China
Hui-Chuan Shih, Department of Nursing, Kaohsiung Military General Hospital, Kaohsing, Taiwan, China
De-Chuan Chan, Division of General Surgery, Tri-Service General Hospital, National Defence Medical Center, Taipei, Taiwan, China
Pesus Chou, Community Medicine Research Center and Institute of Public Health, National Yang-Ming University, Taipei, Taiwan, China
Author contributions: All authors contributed equally to the work.
Supported by the grants from the National Science Council, Nos. NSC-91-2320-B-010-102 and NSC-92-2320-B-010-102
Correspondence to: Dr Pesus Chou, Community Medicine Research Center, National Yang-Ming University, Shih-Pai, 112, Taipei, Taiwan, China. pschou@ym.edu.tw
Telephone: +886-2-28267050 Fax: +886-2-28201461
Received: April 28, 2005
Revised: May 10, 2005
Accepted: May 12, 2005
Published online: December 7, 2005
Abstract

AIM: To explore the association of serum insulin, insulin resistance, and β-cell dysfunction with gallstone disease (GSD) in type 2 diabetics.

METHODS: We used a community-based study conducted between 1991 and 1993 in Kinmen, Taiwan to identify type 2 diabetics. A screening program for GSD was performed in 2001 by a panel of specialists who employed real-time ultrasound sonography to examine the abdominal region after the patient had fasted for at least 8 h. Screening was conducted in 2001 on 848 patients diagnosed with type 2 diabetes. The HOMA method was used to compare the profile differences for insulin resistance (HOMA IR) and β-cell dysfunction (HOMA β-cell).

RESULTS: We studied 440 type 2 diabetics who attended sonography check-ups. After excluding eight insulin-treated diabetics, the prevalence of GSD among the remaining 432 was 13.9% (26/187) among males and 14.7% (36/245) among females. After adjustment for other GSD-associated risk factors in addition to age and obesity, GSD risk increased among females with levels of serum insulin [4thvs 1st quartile odds ratios (OR) = 4.46 (95%CI: 1.71-11.66)] and HOMA IR [4thvs 1st quartile OR = 4.46 (95%CI: 1.71-11.66)]. Better HOMA β-cell function was significantly related to decreased risk of GSD [4thvs 1st quartile OR = 0.16 (95%CI: 0.03-1.70)]. Among males, age and central obesity were the most significant risk factors for GSD. No association of GSD with serum insulin, HOMA IR, and HOMA β-cell was observed among males.

CONCLUSION: Serum insulin, insulin resistance, and β-cell dysfunction are risk factors for GSD in females, but not males with type 2 diabetes.

Keywords: Type 2 diabetes; Gallstone disease; Insulin resistance; β-cell dysfunction; Community-based study