{
  "abstract": "OBJECTIVEThe adipo-B index (adipo-IR divided by HOMA-B) was introduced as an integrator of adipose tissue insulin resistance and pancreatic beta-cell function. Algebraic simplification reveals that insulin cancels from the formula, yielding FFA x (FBG-63)/360 -- a composite of circulating free fatty acids and ambient glycemia. We investigated whether this index predicts beta-cell secretory capacity measured by HOMA-B and C-peptide index (CPR-index) across four therapeutic strategies.\n\nRESEARCH DESIGN AND METHODSA total of 253 treatment-naive subjects with T2DM received monotherapy with modified Japanese diet for diabetes (MJDD, n=61), canagliflozin (n=67), pioglitazone (n=62), or sitagliptin (n=63). Correlations between baseline adipo-B and baseline beta-cell indices, and between their longitudinal changes, were examined. This is a prospective, non-randomized observational study.\n\nRESULTSAt baseline, adipo-B showed significant negative correlations with HOMA-B with all the subjects. At 3 months, adipo-B significantly decreased and HOMA-B significantly increased with all the therapeutic groups. CPR-index significantly improved with canagliflozin and sitagliptin. Pioglitazone showed a trend toward improvement while MJDD demonstrated no changes. Changes in adipo-B ({Delta}adipo-B) significantly and negatively correlated with changes in both HOMA-B and CPR-index in MJDD, canagliflozin, and sitagliptin. With pioglitazone, no such correlations were observed -- consistent with the previously reported bidirectional regulation of insulin secretion by pioglitazone depending on baseline insulin secretory status.\n\nCONCLUSIONSThe adipo-B index predicted beta-cell secretory capacity -- assessed independently by conventional beta-cell indices -- without requiring insulin or C-peptide measurement. These findings suggest adipo-B may serve as a cost-effective surrogate for assessment of beta-cell function in routine clinical settings.\n\nARTICLE HIGHLIGHTSO_LIWhy did we undertake this study? Insulin cancels algebraically from the adipo-B formula, questioning its validity. We tested if adipo-B predicts beta-cell function using the insulin-independent C-peptide index. C_LIO_LIWhat is the specific question we wanted to answer? Does adipo-B predict beta-cell secretory capacity (via HOMA-B and C-peptide index) without requiring insulin or C-peptide measurements? C_LIO_LIWhat did we find? Cross-sectionally, baseline adipo-B negatively correlated with HOMA-B and CPR-index. Longitudinally, {Delta}adipo-B negatively correlated with {Delta}HOMA-B and {Delta}CPR-index for MJDD, canagliflozin, and sitagliptin--but not pioglitazone, reflecting its bidirectional beta-cell regulation. C_LIO_LIWhat are the implications? Adipo-B predicts beta-cell capacity without insulin or C-peptide testing, offering a cost-effective surrogate for routine and resource-limited clinical settings. C_LI",
  "abstract_shown": true,
  "affiliations": [
    "Biomedical Center"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "E. Kutoh"
    },
    {
      "name": "A. Kuto"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3ggy5p31d20bm.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.24.26366378",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.24.26366378v1.full",
  "id": "3ggy5p31d20bm",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.24.26366378v1",
  "language": null,
  "licence": "CC-BY-ND",
  "licence_label": "CC BY-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "endocrinology"
    ],
    [
      "openalex",
      "2712|Diabetes Treatment and Management"
    ]
  ],
  "openalex": "W7223682914",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.24.26366378v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-24",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3ggy5p31d20bm.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:50Z",
      "native_id": "10.64898/2026.10.24.26366378",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.24.26366378v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:endocrinology",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Adipo-B Index as a Novel Predictor of Beta-Cell Secretory Function Without Measuring Insulin: Cross-Therapeutic Validation Against C-Peptide Index in Treatment-Naive Type 2 Diabetes",
  "title_text": "Adipo-B Index as a Novel Predictor of Beta-Cell Secretory Function Without Measuring Insulin: Cross-Therapeutic Validation Against C-Peptide Index in Treatment-Naive Type 2 Diabetes",
  "type": "preprint",
  "updated_at": "2026-10-30T12:21:50Z",
  "url": "https://research.draconitic.com/paper/3ggy5p31d20bm",
  "venue": "medRxiv",
  "versions": []
}