Insulin Resistance and β-Cell Dysfunction in Relation to Cardiometabolic Risk Patterns

Context: Insulin resistance (IR) and β-cell dysfunction are two major defects synergistically inducing the development of diabetes and related cardiometabolic disorders. Objective: To investigate the independent and joint associations of IR and β-cell dysfunction with the prevalence of multiple cardiometabolic disorders, including obesity, central obesity, diabetes, dyslipidemia, and hypertension. Design and Settings: A nationally representative population of 93,690 Chinese adults. Main Outcome Measures: IR and β-cell dysfunction were assessed by the homeostasis model assessment of IR (HOMA-IR) and of β-cell function (HOMA-B), respectively. Results: High HOMA-IR was independently associated with high prevalence of all estimated cardiometabolic disorders, whereas low HOMA-B was independently associated with high prevalence of diabetes, dyslipidemia, and hypertension but low prevalence of obesity and central obesity. When examined jointly, the associations of HOMA-IR and HOMA-B with multiple cardiometabolic disorders showed different patterns with varying magnitudes. The strongest joint associations were observed for diabetes, with low HOMA-B associated with high prevalence of diabetes regardless of HOMA-IR; joint associations with dyslipidemia and hypertension prevalence appeared to be additive and had moderate changing trends; and low HOMA-B was not associated with high prevalence of obesity or central obesity unless combined with high HOMA-IR. Conclusion: IR was associated with more prevalent cardiometabolic disorders than was β-cell dysfunction, and combinations of IR and β-cell dysfunction showed distinct relations with cardiometabolic risk patterns in Chinese adults.