Chugoku Rosai Hospital Research Center for the Promotion of Health and Employment Support, Japan Organization of Occupational Health and Safety, 1-5-1, Hirotagaya, Kure City, Hiroshima 737-0193, Japan.
Department of Internal Medicine, Chugoku Rosai Hospital, 1-5-1, Hirotagaya, Kure City, Hiroshima 737-0193, Japan.
J Diabetes Res. 2019 Mar 12;2019:4916546. doi: 10.1155/2019/4916546. eCollection 2019.
We attempted to clarify the severity of the risk of diabetes mellitus (DM) in the individuals who repeatedly fulfill the criteria for prediabetes in both fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c). The subjects were 2347 individuals who underwent annual health checkup at our hospital. They were classified as normal glucose tolerance or prediabetes as their yearly status of glucose tolerance for three years; furthermore, the individuals classified as prediabetes were subclassified into 3 groups. Among them, we focused the individuals who fulfilled the criteria for prediabetes in both FPG and HbA1c, and this group was named as PD3. Similarly, all subjects were categorized into 4 groups by the frequency of the status of PD3 during three years. Moreover, all subjects were categorized into 8 patterns when PD3 status was positive. Then, we surveyed the development of diabetes for 5 years, and the incidence rates (IRs) and the age- and sex-adjusted odds ratios (ORs) were obtained. A total of 188 subjects developed diabetes. The individuals in the group of PD3 showed the highest IR of DM (33.6%). The values of ORs were 11.5, 20.0, and 63.5 when the frequencies of PD3 were one, two, and three, respectively. In the group whose frequency of PD3 was two, the individuals who had repeated the status of PD3 twice then moved to the status other than PD3 showed smaller risk of DM than the others in the same group. In conclusion, individuals who fulfill the criteria for prediabetes in both FPG and HbA1c were at a high risk of developing DM, and the risk was enhanced by repeating this status. On the other hand, changing the status from PD3 to others might reduce the risk of DM.
我们试图阐明在空腹血糖（FPG）和糖化血红蛋白（HbA1c）均符合糖尿病前期标准的个体中糖尿病（DM）风险的严重程度。研究对象为在我院进行年度健康检查的 2347 名个体。他们根据 3 年的年度葡萄糖耐量状态分为正常糖耐量或糖尿病前期；此外，将糖尿病前期个体分为 3 组。其中，我们关注同时满足 FPG 和 HbA1c 糖尿病前期标准的个体，并将该组命名为 PD3。同样，所有个体均根据 3 年内 PD3 状态的频率分为 4 组。此外，当 PD3 状态为阳性时，所有个体分为 8 种模式。然后，我们对 5 年内的糖尿病发病情况进行了调查，并获得了发病率（IR）和年龄及性别校正的比值比（OR）。共有 188 例患者发展为糖尿病。PD3 组个体的 DM 发病率最高（33.6%）。当 PD3 出现的频率为 1、2 和 3 时，OR 值分别为 11.5、20.0 和 63.5。在 PD3 出现频率为 2 的组中，两次出现 PD3 状态后转为 PD3 以外状态的个体，其 DM 发病风险低于同组其他个体。总之，同时满足 FPG 和 HbA1c 糖尿病前期标准的个体发生 DM 的风险较高，且这种状态重复出现会增加风险。另一方面，从 PD3 状态转为其他状态可能会降低 DM 的发病风险。
