Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea.
Diabetes Metab J. 2019 Aug;43(4):530-538. doi: 10.4093/dmj.2018.0111. Epub 2019 Feb 20.
Metabolic syndrome (MetS) is a known predictor of diabetes mellitus (DM), but whether longitudinal changes in MetS status modify the risk for DM remains unclear. We investigated whether changes in MetS status over 2 years modify the 10-year risk of incident DM.
We analyzed data from 7,317 participants aged 40 to 70 years without DM at baseline, who took part in 2001 to 2011 Korean Genome Epidemiology Study. Subjects were categorized into four groups based on repeated longitudinal assessment of MetS status over 2 years: non-MetS, resolved MetS, incident MetS, and persistent MetS. The hazard ratio (HR) of new-onset DM during 10 years was calculated in each group using Cox models.
During the 10-year follow-up, 1,099 participants (15.0%) developed DM. Compared to the non-MetS group, the fully adjusted HRs for new-onset DM were 1.28 (95% confidence interval [CI], 0.92 to 1.79) in the resolved MetS group, 1.75 (95% CI, 1.30 to 2.37) in the incident MetS group, and 1.98 (95% CI, 1.50 to 2.61) in the persistent MetS group ( for trend <0.001). The risk of DM in subjects with resolved MetS was significantly attenuated compared to those with persistent MetS over 2 years. In addition, the adjusted HR for 10-year developing DM gradually increased as the number of MetS components increased 2 years later.
We found that discrete longitudinal changes pattern in MetS status over 2 years associated with 10-year risk of DM. These findings suggest that monitoring change of MetS status and controlling it in individuals may be important for risk prediction of DM.
代谢综合征(MetS)是糖尿病(DM)的已知预测因子,但 MetS 状态的纵向变化是否会改变 DM 的风险尚不清楚。我们研究了 2 年内 MetS 状态的变化是否会改变 DM 的 10 年发病风险。
我们分析了来自 2001 年至 2011 年韩国基因组流行病学研究中未患有 DM 的 7317 名年龄在 40 至 70 岁之间的参与者的数据。根据 2 年内重复的 MetS 状态纵向评估,将受试者分为四组:非 MetS、缓解 MetS、新发 MetS 和持续 MetS。使用 Cox 模型计算每组在 10 年内新发生 DM 的风险比(HR)。
在 10 年的随访期间,1099 名参与者(15.0%)发生 DM。与非 MetS 组相比,缓解 MetS 组新发生 DM 的校正 HR 为 1.28(95%置信区间 [CI],0.92 至 1.79),新发 MetS 组为 1.75(95% CI,1.30 至 2.37),持续 MetS 组为 1.98(95% CI,1.50 至 2.61)(趋势 P<0.001)。与持续 2 年的 MetS 相比,缓解 MetS 的受试者发生 DM 的风险显著降低。此外,随着 2 年后 MetS 成分数量的增加,校正后的 10 年 DM 发病风险 HR 逐渐增加。
我们发现,2 年内 MetS 状态的离散纵向变化模式与 10 年 DM 发病风险相关。这些发现表明,监测 MetS 状态的变化并控制其在个体中的发展可能对 DM 的风险预测很重要。