AIMS Insulin resistance (IR) changes over time during the development of type 2 diabetes. Some reports showed that obesity was associated with progression of IR. However, no study has explored if change of IR predicts incident diabetes, and no study has investigated other factors associated with the change. METHODS In this study, 1184 subjects without diabetes at baseline were enrolled in 2006-2016 with a median follow-up period of 4.5 years. Diabetes was diagnosed by oral glucose tolerance test and hemoglobin A1c, or if anti-diabetic agents were used. HOMA2-IR and ISI0,120 were used to estimate IR. RESULTS The annual changes of HOMA2-IR(ΔHOMA2-IR/year) and ISI0,120(ΔISI0,120/year) were associated with BMI, waist circumference(WC), glucose, HbA1c, triglyceride and HDL-cholesterol. Subjects with pre-diabetes or metabolic syndrome were associated with a more rapid increase of IR. ΔHOMA2-IR/year and ΔISI0,120/year were correlated with annual changes of BMI and WC. The hazard ratios for ΔHOMA2-IR/year and ΔISI0,120/year to predict incident diabetes were 1.39 (95% CI 1.22-1.59, p < 0.001) and 0.13 (95% CI 0.09-0.19, p < 0.001) in adjusted models, respectively. CONCLUSIONS Change of IR can be used as a surrogate marker of incident diabetes. The progression of IR is an important pathophysiologic link between risk factors and the incidence of diabetes.

中文翻译：

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胰岛素抵抗的进展：危险因素与糖尿病发生率之间的联系。

在2型糖尿病发展过程中，AIMS胰岛素抵抗（IR）随时间而变化。一些报道表明，肥胖与IR的发展有关。但是，没有研究探讨IR的变化是否可以预测糖尿病的发生，也没有研究调查与变化有关的其他因素。方法在本研究中，2006年至2016年招募了1184名基线时无糖尿病的受试者，中位随访期为4.5年。通过口服葡萄糖耐量试验和血红蛋白A1c来诊断糖尿病，或者是否使用了抗糖尿病药。HOMA2-IR和ISI0,120用于估计IR。结果HOMA2-IR（ΔHOMA2-IR/年）和ISI0,120（ΔISI0,120/年）的年变化与体重指数，腰围（WC），葡萄糖，HbA1c，甘油三酸酯和高密度脂蛋白胆固醇有关。患有糖尿病前期或代谢综合征的受试者与IR的快速增加相关。ΔHOMA2-IR/年和ΔISI0,120/年与BMI和WC的年度变化相关。在调整后的模型中，预测患糖尿病的ΔHOMA2-IR/年和ΔISI0,120/年的危险比分别为1.39（95％CI 1.22-1.59，p <0.001）和0.13（95％CI 0.09-0.19，p <0.001） ， 分别。结论IR的改变可以作为糖尿病的替代指标。IR的进展是危险因素与糖尿病发生率之间的重要病理生理联系。p <0.001）。结论IR的改变可以作为糖尿病的替代指标。IR的进展是危险因素与糖尿病发生率之间的重要病理生理联系。p <0.001）。结论IR的改变可以作为糖尿病的替代指标。IR的进展是危险因素与糖尿病发生率之间的重要病理生理联系。