PAST AND CURRENT OBESITY IN KOREANS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

To determine the prevalence of past and current obesity among patients with non-insulin-dependent diabetes mellitus (NIDDM) and to define th e clinical characteristics of non-obese NIDDM patients in South Korea, we studied a cross-section of 749 NIDDM patients and a group of age- and sex-matched control subjects. Current height, weight and waist-to- hip ratio (WHR), the history of weight changes and the family history of diabetes were recorded. Obesity was defined as body mass index (BMI ) > 25 kg/m(2). The maximum lifetime BMI of diabetic patients was sign ificantly higher than that of control subjects (P < 0.001). Compared w ith control subjects, current BMI was higher in diabetic women (P < 0. 001) but not in diabetic men. In contrast, WHR of both diabetic men an d women were significantly higher than those of controls (P < 0.05). B MI and WHR correlated significantly with fasting C-peptide levels and log-triglyceride levels in NIDDM patients. As a whole, 72% of the Sout h Korean NIDDM patients had a history of past obesity as assessed by t heir maximum weight, while only 38% of them were currently obese. Comp ared with obese patients, non-obese patients were characterized by low er fasting serum C-peptide levels (P < 0.001), a higher percentage of insulin treatment (P < 0.05), lower maximum BMI (P < 0.001) and more p ronounced weight loss from the time at their maximum weight (P < 0.001 ). In summary, increased upper body adiposity and a history of past ob esity were associated with NIDDM in South Korea. Although most South K orean NIDDM patients were previously obese, many of them were currentl y not obese. Lower maximum BMI, lower serum C-peptide levels and a hig her percentage of insulin treatment in non-obese NIDDM patients sugges t that the capacity to increase insulin secretion in response to incre asing weight gain is rather limited in these patients. (C) 1997 Elsevi er Science Ireland Ltd.