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Peer-reviewedCC BY-NC 4.0Diabetes, Obesity & Metabolism

OGTT‐Derived β‐Cell Function–Based Stratification of 2‐Year Glycaemic Transitions in Chinese Adults With Prediabetes

  • Yuntong Liu1,2
  • Liping Yu1
  • Dongli Zhu3
  • Zhenping Li3
  • Jinping Zhang1
  • Lingding Xie1
  • Lulu Song1
  • Yifan He1
  • Xian Jin1
  • Zhaoqing Li1
  • Ruifen Deng1
  • Wanlu Ma1
2 more authors
  • Cong Zhang1
  • Bo Zhang1
  1. 1Department of Endocrinology China‐Japan Friendship Hospital Beijing China
  2. 2Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China
  3. 3Daqing Oilfield General Hospital Daqing Heilongjiang China
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Abstract

Aims: Prediabetes is heterogeneous, with variable progression to diabetes or reversion to normoglycemia. We evaluated whether the insulin secretion‐sensitivity index‐2 (ISSI‐2), an oral glucose tolerance test (OGTT)‐derived integrated surrogate of β‐cell function relative to insulin sensitivity and prevailing glycemia, was associated with baseline glycaemic profiles and 2‐year transitions in Chinese adults with prediabetes. We also examined whether these associations differed from those of the homeostasis model assessment of insulin resistance (HOMA‐IR) and whether cohort‐specific index‐based groups combining ISSI‐2 and HOMA‐IR stratified transition risk.

Materials and Methods: We analysed 645 Chinese adults with prediabetes and complete baseline OGTT glucose and insulin measurements from a multicentre lifestyle intervention cohort; 410 had 2‐year outcomes. ISSI‐2 and HOMA‐IR were examined in relation to baseline glycaemic measures and 2‐year progression or reversion using multivariable regression.

Results: Higher ISSI‐2 was associated with lower FPG, 1‐h PG, 2‐h PG and HbA1c, with the strongest association observed for 1‐h PG (β per 1‐SD increase −1.189 mmol/L; p < 0.001). During follow‐up, 136 participants progressed to diabetes and 61 reverted to normoglycemia. Each 1‐SD increase in ISSI‐2 was associated with lower progression risk (OR 0.505, 95% CI: 0.382–0.668) and higher likelihood of reversion (OR 1.447, 95% CI: 1.106–1.893), whereas HOMA‐IR showed less consistent associations. Compared with the Low IR + higher ISSI‐2 group, the dual‐defect group (higher HOMA‐IR and lower ISSI‐2) had higher progression risk (OR 2.764, 95% CI: 1.459–5.237).

Conclusions: ISSI‐2 was associated with baseline glycaemic profiles and bidirectional 2‐year transitions in Chinese adults with prediabetes. OGTT‐derived β‐cell function assessment may complement conventional glycaemic classification for short‐term risk stratification, pending validation in independent cohorts.

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Cite

BibTeXRIS
BibTeX
@article{liu2026ogttderived,
  title = {{OGTT‐Derived β‐Cell Function–Based Stratification of 2‐Year Glycaemic Transitions in Chinese Adults With Prediabetes}},
  author = {Yuntong Liu and Liping Yu and Dongli Zhu and Zhenping Li and Jinping Zhang and Lingding Xie and Lulu Song and Yifan He and Xian Jin and Zhaoqing Li and Ruifen Deng and Wanlu Ma and Cong Zhang and Bo Zhang},
  journal = {Diabetes, Obesity \& Metabolism},
  year = {2026},
  month = sep,
  doi = {10.1111/dom.71310},
  url = {https://doi.org/10.1111/dom.71310},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - OGTT‐Derived β‐Cell Function–Based Stratification of 2‐Year Glycaemic Transitions in Chinese Adults With Prediabetes
AU  - Yuntong Liu
AU  - Liping Yu
AU  - Dongli Zhu
AU  - Zhenping Li
AU  - Jinping Zhang
AU  - Lingding Xie
AU  - Lulu Song
AU  - Yifan He
AU  - Xian Jin
AU  - Zhaoqing Li
AU  - Ruifen Deng
AU  - Wanlu Ma
AU  - Cong Zhang
AU  - Bo Zhang
PY  - 2026
DA  - 2026/09/13
JO  - Diabetes, Obesity & Metabolism
DO  - 10.1111/dom.71310
UR  - https://doi.org/10.1111/dom.71310
AB  - Aims: Prediabetes is heterogeneous, with variable progression to diabetes or reversion to normoglycemia. We evaluated whether the insulin secretion‐sensitivity index‐2 (ISSI‐2), an oral glucose tolerance test (OGTT)‐derived integrated surrogate of β‐cell function relative to insulin sensitivity and prevailing glycemia, was associated with baseline glycaemic profiles and 2‐year transitions in Chinese adults with prediabetes. We also examined whether these associations differed from those of the homeostasis model assessment of insulin resistance (HOMA‐IR) and whether cohort‐specific index‐based groups combining ISSI‐2 and HOMA‐IR stratified transition risk.  Materials and Methods: We analysed 645 Chinese adults with prediabetes and complete baseline OGTT glucose and insulin measurements from a multicentre lifestyle intervention cohort; 410 had 2‐year outcomes. ISSI‐2 and HOMA‐IR were examined in relation to baseline glycaemic measures and 2‐year progression or reversion using multivariable regression.  Results: Higher ISSI‐2 was associated with lower FPG, 1‐h PG, 2‐h PG and HbA1c, with the strongest association observed for 1‐h PG (β per 1‐SD increase −1.189 mmol/L; p < 0.001). During follow‐up, 136 participants progressed to diabetes and 61 reverted to normoglycemia. Each 1‐SD increase in ISSI‐2 was associated with lower progression risk (OR 0.505, 95% CI: 0.382–0.668) and higher likelihood of reversion (OR 1.447, 95% CI: 1.106–1.893), whereas HOMA‐IR showed less consistent associations. Compared with the Low IR + higher ISSI‐2 group, the dual‐defect group (higher HOMA‐IR and lower ISSI‐2) had higher progression risk (OR 2.764, 95% CI: 1.459–5.237).  Conclusions: ISSI‐2 was associated with baseline glycaemic profiles and bidirectional 2‐year transitions in Chinese adults with prediabetes. OGTT‐derived β‐cell function assessment may complement conventional glycaemic classification for short‐term risk stratification, pending validation in independent cohorts.
SN  - 1462-8902
SN  - 1463-1326
ER  -