Park Yong-Woo, Chang Yoosoo, Sung Ki Chul, Ryu Seungho, Sung Eunju, Kim Won Sool
Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Jongno-Gu, Seoul, Republic of Korea.
Diabetes Res Clin Pract. 2006 Sep;73(3):329-35. doi: 10.1016/j.diabres.2006.02.006. Epub 2006 Apr 4.
We assessed whether the increased sequential changes in the fasting plasma glucose level (FPG) that is still within the normoglycemic range could be a predictor for future diabetes.
A prospective cohort study was conducted with 5296 male employees, aged 31-44 years. A sequential change in the FPG level was defined as the first follow-up FPG level minus the baseline FPG level. The incident diabetes was assessed at annual examinations during the next 4.1 years. Cox proportional hazard analyses were performed.
During the 21,575.5 person-years follow-up among the 5,296 subjects, a total of 156 incident cases of type 2 diabetes occurred (116 cases among the 4,975 normoglycemic subjects and 40 cases among the 321 subjects with impaired fasting glucose). An increase in the FPG level from the baseline to the first follow-up, although still within the normoglycemic range (FPG<100 mg/dl), significantly predicted future diabetes: the multivariate hazard ratios associated with the sequential changes in the FPG of <-3, -3 to 3, 4-6, 7-9, and >9 mg/dl were 0.75, 1.00 (reference), 2.28, 3.28, and 6.10, respectively (p for trend <0.001).
The increase of the sequential changes in the FPG level that were within the normal glucose range was associated with a higher risk for developing diabetes. Thus, conducting assessment for the serial changes in the FPG level may help to identify the young, healthy, normoglycemic individuals at risk for type 2 diabetes.
我们评估了空腹血糖水平（FPG）仍在正常血糖范围内但出现的连续变化是否可作为未来患糖尿病的预测指标。
对5296名年龄在31 - 44岁的男性员工进行了一项前瞻性队列研究。FPG水平的连续变化定义为首次随访FPG水平减去基线FPG水平。在接下来的4.1年年度检查中评估糖尿病发病情况。进行了Cox比例风险分析。
在5296名受试者的21575.5人年随访期间，共发生156例2型糖尿病新发病例（4975名血糖正常受试者中有116例，321名空腹血糖受损受试者中有40例）。从基线到首次随访FPG水平升高，尽管仍在正常血糖范围内（FPG < 100 mg/dl），但显著预测了未来患糖尿病的风险：FPG连续变化<-3、-3至3、4 - 6、7 - 9和>9 mg/dl的多变量风险比分别为0.75、1.00（参照）、2.28、3.28和6.10（趋势p < 0.001）。
正常血糖范围内FPG水平连续变化的增加与患糖尿病的较高风险相关。因此，对FPG水平的连续变化进行评估可能有助于识别有2型糖尿病风险的年轻、健康、血糖正常个体。
