Department of Endocrinology and Metabolism, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Endocrinology and Metabolism, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Endocrinology and Metabolism , Shanghai Clinical Center for Endocrine and Metabolic Diseases , Shanghai Institute of Endocrine and Metabolic Diseases, RuiJin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai , China.
BMJ Open Diabetes Res Care. 2016 May 10;4(1):e000169. doi: 10.1136/bmjdrc-2015-000169. eCollection 2016.
To investigate the gender-related affecting factors of prediabetes on its 10-year outcome, in a longitudinal study.
This longitudinal population-based study was performed in the Ping Liang community, Yangpu district, Shanghai, between November 2002 and October 2014. There were 334 participants with prediabetes enrolled in the final analysis. While a certain proportion of the prediabetic population progress to diabetes, the majority remain at the same level or even revert to normal glucose regulation. No gender difference was observed in the change of glucose regulation. However, results from an adjusted logistic regression analysis in males showed that physical activity was significantly associated with both elevated odds of reverting to normal glucose regulation (active vs inactive, OR 3.00, 95% CI 1.09 to 8.30) and developing diabetes (OR 0.34, 95% CI 0.13 to 0.92). Age, baseline 2 h glucose, triglycerides and smoking status were also risk factors significantly associated with diabetes development; while for females, waist circumference played a key role in the outcome. Every unit elevation of waist circumference was associated with lower odds of reverting to normal glucose regulation (OR, 0.94; 95% CI 0.89 to 0.98) and higher odds of progressing to diabetes (OR, 1.05; 95% CI 1.01 to 1.10). Baseline hypertension and family history of diabetes carried higher risk for developing diabetes as well.
Physical activity in males and waist circumference in females are important factors predicting both progression to diabetes and regression to normal glucose regulation, indicating that more exercise for males and lower waist circumference for females are beneficial for prediabetes to achieve reversion.
在一项纵向研究中,探讨糖尿病前期性别相关影响因素及其 10 年结局。
本项基于人群的纵向研究在上海市杨浦区平凉社区进行,时间为 2002 年 11 月至 2014 年 10 月。最终共有 334 例糖尿病前期患者纳入最终分析。尽管部分糖尿病前期患者的血糖水平会进展为糖尿病,但大多数患者的血糖水平保持不变,甚至恢复正常。在血糖调节变化方面,未观察到性别差异。然而,对男性进行调整后的 logistic 回归分析结果显示,体力活动与恢复正常血糖调节的几率增加显著相关(活跃与不活跃相比,OR=3.00,95%CI:1.09-8.30),与发生糖尿病的几率降低显著相关(OR=0.34,95%CI:0.13-0.92)。年龄、基线 2 小时血糖、甘油三酯和吸烟状态也是与糖尿病发展显著相关的危险因素;而对于女性,腰围是影响结局的关键因素。腰围每升高 1 个单位,恢复正常血糖调节的几率就会降低(OR=0.94,95%CI:0.89-0.98),发生糖尿病的几率就会升高(OR=1.05,95%CI:1.01-1.10)。基线高血压和糖尿病家族史也与发生糖尿病的风险增加相关。
男性的体力活动和女性的腰围是预测糖尿病进展和血糖恢复正常的重要因素,这表明男性应增加运动量,女性应降低腰围,有利于糖尿病前期患者恢复正常血糖水平。