Kurotani Kayo, Miyamoto Toshiaki, Kochi Takeshi, Eguchi Masafumi, Imai Teppei, Nishihara Akiko, Tomita Kentaro, Uehara Akihiko, Yamamoto Makoto, Murakami Taizo, Shimizu Chii, Shimizu Makiko, Nagahama Satsue, Nakagawa Tohru, Honda Toru, Yamamoto Shuichiro, Okazaki Hiroko, Sasaki Naoko, Hori Ai, Nishiura Chihiro, Kuwahara Keisuke, Kuroda Reiko, Akter Shamima, Kashino Ikuko, Nanri Akiko, Kabe Isamu, Mizoue Tetsuya, Kunugita Naoki, Dohi Seitaro
National Center for Global Health and Medicine, Tokyo, Japan.
Nippon Steel & Sumitomo Metal Corporation Kimitsu Works, Chiba, Japan.
J Epidemiol. 2017 Sep;27(9):408-412. doi: 10.1016/j.je.2016.08.015. Epub 2017 Apr 20.
We prospectively examined the association of diabetes risk with the number of metabolic abnormalities, as well as their combinations, according to the presence or absence of impaired fasting glucose (IFG) in a large-scale Japanese working population.
Participants included 55,271 workers at 11 companies who received periodic health check-ups between 2008 and 2013. The metabolic syndrome (MetS) components were defined using the 2009 Joint Interim Statement. IFG was defined as fasting plasma glucose 5.6-6.9 mmol/L. Diabetes newly diagnosed after the baseline examination was defined according to the American Diabetes Association criteria. We calculated the hazard ratios (HRs) for diabetes incidence using the Cox proportional hazards model.
During the follow-up period (median 4.95 years), 3183 subjects developed diabetes. In individuals with normal fasting glucose levels, the risk of diabetes increased steadily with the increasing number of MetS components; the multivariable-adjusted HRs for incident diabetes for the number of MetS components were 2.0, 4.3, 7.0, and 10.0 for one, two, three, or four MetS components, respectively, compared with the absence of components. A similar association was observed among individuals with IFG; the corresponding HRs were 17.6, 23.8, 33.9, and 40.7. The combinations that included central obesity appeared to be more strongly associated with diabetes risk than other combinations with the same number of MetS components within the same glucose status.
Our findings indicate that risk stratification of individuals by the presence or absence of IFG and the number of MetS components can detect individuals with a high risk of diabetes.
我们前瞻性地研究了在日本大规模在职人群中，根据空腹血糖受损（IFG）的有无，糖尿病风险与代谢异常数量及其组合之间的关联。
参与者包括11家公司的55271名员工，他们在2008年至2013年期间接受了定期健康检查。代谢综合征（MetS）的组成部分根据2009年联合临时声明进行定义。IFG被定义为空腹血糖5.6 - 6.9毫摩尔/升。基线检查后新诊断的糖尿病根据美国糖尿病协会标准进行定义。我们使用Cox比例风险模型计算糖尿病发病率的风险比（HRs）。
在随访期间（中位时间4.95年），3183名受试者患糖尿病。在空腹血糖水平正常的个体中，糖尿病风险随着MetS组成部分数量的增加而稳步上升；与无MetS组成部分相比，MetS组成部分数量为1、2、3或4个时，多变量调整后的糖尿病发病HRs分别为2.0、4.3、7.0和10.0。在IFG个体中也观察到类似的关联；相应的HRs分别为17.6、23.8、33.9和40.7。在相同血糖状态下，包含中心性肥胖的组合似乎比具有相同数量MetS组成部分的其他组合与糖尿病风险的关联更强。
我们的研究结果表明，根据IFG的有无和MetS组成部分的数量对个体进行风险分层，可以检测出糖尿病高风险个体。
