Shen X X, Wang J P, Chen Y Y, An Y L, Gong Q H, Zhang B, Hong J, Shuai Y, Zhao F, Li H, Li G W
Center of Endocrinology and Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100037, China.
Department of Cardiology, Da Qing First Hospital, Daqing 163000, China.
Zhonghua Nei Ke Za Zhi. 2019 May 1;58(5):372-376. doi: 10.3760/cma.j.issn.0578-1426.2019.05.008.
To explore the influence of lifestyle intervention on long-term diabetes in subjects with impaired glucose tolerance (IGT) returned to normal glucose tolerance (NGT) within 6 years. A total of 577 subjects (aged 25-74 years old) with IGT in Daqing were enrolled and randomly assigned to control, and diet, exercise and diet plus exercise groups in a six-year intervention trial in 1986. Subjects who were non-diabetic at the end of the intervention were followed up for additional 14 years. Among all the subjects, 41.38% of them who had returned to NGT from IGT within 6 years maintained NGT status after 20 years, and had a lower incidence of diabetes than subjects maintained IGT status (46.55% vs. 75.25%). Of note, in the intervention group, the percentage of participants developed diabetes in the NGT subjects was significantly lower than that in the IGT group (43.71% vs. 76.25%) after 20 years. There was high long-term risk for diabetes in the IGT subjects after the adjustment of age, sex and baseline glucose (=1.81, 95 1.27-2.58, 0.001), whereas in the non-intervention group, no significant difference could be viewed in long-term diabetic risk between subjects maintained IGT status and those returned to NGT (71.43% vs. 65.22%) after adjusting of the same confounders (=1.03, 95% 0.45-2.35, 0.94). IGT subjects who had returned to NGT in early years had lower risk for future diabetes than those who remained IGT. However, this beneficial effect could only be viewed in the intervention group, but not in the non-intervention group.
探讨生活方式干预对6年内糖耐量受损（IGT）恢复至正常糖耐量（NGT）的受试者长期糖尿病的影响。1986年，大庆市共有577名年龄在25 - 74岁的IGT受试者被纳入一项为期六年的干预试验，并随机分为对照组、饮食组、运动组和饮食加运动组。干预结束时非糖尿病的受试者又被随访了14年。在所有受试者中，6年内从IGT恢复至NGT的人群中有41.38%在20年后仍维持NGT状态，且糖尿病发病率低于维持IGT状态的受试者（46.55%对75.25%）。值得注意的是，干预组中NGT受试者20年后患糖尿病的比例显著低于IGT组（43.71%对76.25%）。调整年龄、性别和基线血糖后，IGT受试者患糖尿病的长期风险较高（=1.81，95%可信区间1.27 - 2.58，P = 0.001），而在非干预组中，调整相同混杂因素后，维持IGT状态的受试者与恢复至NGT的受试者在长期糖尿病风险上无显著差异（71.43%对65.22%，=1.03，95%可信区间0.45 - 2.35，P = 0.94）。早年恢复至NGT的IGT受试者未来患糖尿病的风险低于仍维持IGT状态的受试者。然而，这种有益效果仅在干预组中可见，在非干预组中则未观察到。
