Department of Biochemistry and Molecular Biology, University of Santiago de Compostela, 15782, Santiago de Compostela, Spain.
Clinical Biochemistry Laboratory, Complejo Hospitalario Universitario de Santiago, Travesía de la Choupana s/n, 15706, Santiago de Compostela, Spain.
Acta Diabetol. 2019 Sep;56(9):1023-1030. doi: 10.1007/s00592-019-01342-5. Epub 2019 May 21.
To investigate, in a sample of nondiabetic adults from a Spanish community, the differences between prediabetes as defined by HbA ("H-prediabetes") and by fasting plasma glucose (FPG) ("F-prediabetes") in regard to prevalence and the influence of potential risk factors, adjusting the latter for confounders.
A total of 1328 nondiabetic participants aged ≥ 18 years were classified as normoglycemic, H-prediabetic [HbA 5.7-6.4% (39-47 mmol/mol)] or F-prediabetic (FPG 5.6-6.9 mmol/L). Multivariable analyses were used to compare the impacts of risk factors on the prevalence of H-prediabetes, F-prediabetes and their conjunctive and disjunctive combinations ("HaF-prediabetes" and "HoF-prediabetes," respectively).
Some 29.9% of participants were HoF-prediabetic, 21.7% H-prediabetic, 16.3% F-prediabetic and only 8.1% HaF-prediabetic. Whatever the definition of prediabetes, increasing age, fasting insulin and LDL cholesterol were each a risk factor after adjustment for all other variables. Increasing BMI and decreasing mean corpuscular hemoglobin (MCH) were additional risk factors for H-prediabetes; male sex and increasing uric acid for F-prediabetes and increasing BMI for HaF-prediabetes. The participants satisfying the compound condition "hypertension or hyperlipidemia or obesity or hyperuricemia" (59.9% of the whole study group) included 83.1% of all subjects with HoF-prediabetes.
In this population, the most sensitive risk factor for detection of prediabetes was age, followed by fasting insulin, LDL cholesterol, BMI, MCH, male sex and uric acid, with differences depending on the definition of prediabetes. MCH, an indirect measure of erythrocyte survival, significantly influences the prevalence of HbA-defined prediabetes. This study suggests that screening of individuals with selected risk factors may identify a high proportion of prediabetic persons.
在一个西班牙社区的非糖尿病成年人样本中，调查根据糖化血红蛋白（HbA）定义的“HbA 前期糖尿病”（H-前期糖尿病）与根据空腹血浆葡萄糖（FPG）定义的“FPG 前期糖尿病”（F-前期糖尿病）之间的差异，包括患病率和潜在危险因素的影响，并为混杂因素调整后者。
共有 1328 名年龄≥18 岁的非糖尿病参与者被分类为血糖正常、H-前期糖尿病（HbA 5.7-6.4%[39-47mmol/mol]）或 F-前期糖尿病（FPG 5.6-6.9mmol/L）。多变量分析用于比较危险因素对 H-前期糖尿病、F-前期糖尿病及其联合和离散组合（分别为“HaF 前期糖尿病”和“HoF 前期糖尿病”）患病率的影响。
约 29.9%的参与者为 HoF 前期糖尿病，21.7%为 H-前期糖尿病，16.3%为 F-前期糖尿病，只有 8.1%为 HaF 前期糖尿病。无论前期糖尿病的定义如何，调整所有其他变量后，年龄增长、空腹胰岛素和 LDL 胆固醇都是危险因素。增加 BMI 和降低平均红细胞血红蛋白（MCH）是 H-前期糖尿病的额外危险因素；男性和增加尿酸是 F-前期糖尿病的危险因素，增加 BMI 是 HaF 前期糖尿病的危险因素。符合“高血压或高血脂或肥胖或高尿酸血症”复合条件的参与者（整个研究组的 59.9%）包括所有 HoF 前期糖尿病患者的 83.1%。
在该人群中，检测前期糖尿病最敏感的危险因素是年龄，其次是空腹胰岛素、LDL 胆固醇、BMI、MCH、男性和尿酸，这取决于前期糖尿病的定义。MCH 是红细胞生存的间接测量指标，对 HbA 定义的前期糖尿病的患病率有显著影响。本研究表明，对具有特定危险因素的个体进行筛查可能会识别出大量的前期糖尿病患者。
