Department of Hygiene and Preventive Medicine, Okayama University Medical School, Okayama City,
Environ Health Prev Med. 2001 Jul;6(2):127-31. doi: 10.1007/BF02897959.
Borderline diabetes, a precursory condition of diabetes, is an important issue in the prevention of diabetes. The aim of the present study was to clarify the effects of one-year changes in obesity and exercise on the development of diabetes or return to normal fasting plasma glucose (FPG) levels among middle-aged people with impaired fasting glucose (IFG) at baseline.
Among those who attended a basic health examination in 1997, we selected 1,620 subjects who showed impaired fasting glucose (FPG of 110 mg/dl or higher) and had complete data on height, weight and exercise. At the one-year follow-up (in 1998), 1,099 of those subjects attended a health examination; FPG, height, weight and exercise were evaluated for 731 subjects. Subjects were classified into the following three groups, on the basis of changes in FPG during the year between the two examinations: developing diabetes (DM), remaining IFG, and returning to normal (WNL).
Among those who were initially obese, there was a significant difference in the proportions of DM, IFG and WNL between those with and without improvement in obesity in the year preceding the follow-up (p<0.05). Those with improvement in obesity showed a significantly higher tendency to return to WNL than those without improvement in obesity. Multiple logistic regression analysis showed that those with improvement in obesity had a significantly higher odds ratio (2.17) to return to WNL (p=0.015). Among those who were initially not obese, there was no significant association between changes in obesity and developing DM or returning to WNL. No significant association was observed between changes in exercise and developing DM or returning to WNL.
The present findings suggest that, among obese IFG subjects, improvement in obesity is associated with returning to normal plasma glucose. Weight control may be important for the normalization of borderline diabetes.
边缘性糖尿病是糖尿病的前期状态，是糖尿病预防的一个重要问题。本研究的目的是阐明肥胖和运动在一年中的变化对空腹血糖受损（IFG）人群中糖尿病的发展或恢复正常空腹血糖（FPG）水平的影响。
在 1997 年参加基本健康检查的人群中，我们选择了 1620 名空腹血糖受损（FPG 为 110mg/dl 或更高）且身高、体重和运动数据完整的受试者。在一年的随访（1998 年）中，有 1099 名受试者参加了健康检查；对 731 名受试者评估了 FPG、身高、体重和运动。根据两次检查之间一年中 FPG 的变化，将受试者分为以下三组：发展为糖尿病（DM）、持续 IFG 和恢复正常（WNL）。
在最初肥胖的受试者中，在随访前一年肥胖改善与未改善的受试者中，DM、IFG 和 WNL 的比例存在显著差异（p<0.05）。肥胖改善的受试者恢复到 WNL 的趋势明显高于肥胖未改善的受试者。多因素逻辑回归分析显示，肥胖改善的受试者恢复到 WNL 的比值比（OR）显著升高（2.17，p=0.015）。在最初不肥胖的受试者中，肥胖变化与发展为 DM 或恢复到 WNL 之间没有显著相关性。运动变化与发展为 DM 或恢复到 WNL 之间也没有显著相关性。
本研究结果表明，在肥胖的 IFG 受试者中，肥胖的改善与恢复正常血糖有关。体重控制对于边缘性糖尿病的正常化可能很重要。
