Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, 14000, Mexico City, Mexico.
MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de Mexico, Mexico City, Mexico.
BMC Endocr Disord. 2019 Apr 28;19(1):41. doi: 10.1186/s12902-019-0361-8.
Type 2 diabetes mellitus (T2D) is a leading cause of morbidity and mortality in Mexico. Here, we aimed to report incidence rates (IR) of type 2 diabetes in middle-aged apparently-healthy Mexican adults, identify risk factors associated to ID and develop a predictive model for ID in a high-risk population.
Prospective 3-year observational cohort, comprised of apparently-healthy adults from urban settings of central Mexico in whom demographic, anthropometric and biochemical data was collected. We evaluated risk factors for ID using Cox proportional hazard regression and developed predictive models for ID.
We included 7636 participants of whom 6144 completed follow-up. We observed 331 ID cases (IR: 21.9 per 1000 person-years, 95%CI 21.37-22.47). Risk factors for ID included family history of diabetes, age, abdominal obesity, waist-height ratio, impaired fasting glucose (IFG), HOMA2-IR and metabolic syndrome. Early-onset ID was also high (IR 14.77 per 1000 person-years, 95%CI 14.21-15.35), and risk factors included HOMA-IR and IFG. Our ID predictive model included age, hypertriglyceridemia, IFG, hypertension and abdominal obesity as predictors (D = 0.487, c-statistic = 0.741) and had higher predictive accuracy compared to FINDRISC and Cambridge risk scores.
ID in apparently healthy middle-aged Mexican adults is currently at an alarming rate. The constructed models can be implemented to predict diabetes risk and represent the largest prospective effort for the study metabolic diseases in Latin-American population.
2 型糖尿病（T2D）是墨西哥发病率和死亡率的主要原因。在这里，我们旨在报告中年墨西哥成年人中 2 型糖尿病的发病率（IR），确定与 ID 相关的危险因素，并为高危人群开发 ID 预测模型。
前瞻性 3 年观察性队列，由墨西哥中部城市环境中的看似健康的成年人组成，收集了人口统计学、人体测量学和生化数据。我们使用 Cox 比例风险回归评估 ID 的危险因素，并开发了 ID 的预测模型。
我们纳入了 7636 名参与者，其中 6144 名完成了随访。我们观察到 331 例 ID 病例（IR：21.9/1000 人年，95%CI 21.37-22.47）。ID 的危险因素包括糖尿病家族史、年龄、腹部肥胖、腰围身高比、空腹血糖受损（IFG）、HOMA2-IR 和代谢综合征。早发 ID 也很高（IR 14.77/1000 人年，95%CI 14.21-15.35），危险因素包括 HOMA-IR 和 IFG。我们的 ID 预测模型包括年龄、高三酰甘油血症、IFG、高血压和腹部肥胖作为预测因子（D=0.487，C 统计量=0.741），与 FINDRISC 和剑桥风险评分相比，具有更高的预测准确性。
目前，中年墨西哥成年人的 ID 发病率令人震惊。构建的模型可用于预测糖尿病风险，代表了拉丁美洲人群代谢性疾病研究的最大前瞻性努力。
