Gujral Unjali P, Narayan K M Venkat, Kandula Namratha R, Liu Kiang, Kanaya Alka M
Rollins School of Public Health, Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA
Hubert Department of Global Health, Emory RSPH, Atlanta, Georgia, USA.
BMJ Open Diabetes Res Care. 2020 Jul;8(1). doi: 10.1136/bmjdrc-2019-001063.
South Asians have a high prevalence of type 2 diabetes mellitus (T2DM). This may be associated with high rates of conversion through the natural history of disease. However, there is a paucity of data on prediabetes and T2DM incidence and related predictors in South Asians in the USA.
We estimated prediabetes and T2DM incidence after 5 years of follow-up in the Mediators of Atherosclerosis in South Asians Living in America study (n=481) and examined the associated correlates. We defined T2DM and prediabetes using the American Diabetes Association criteria. Prediabetes included isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT) and combined IFG and IGT.
Overall, 152 (32%, 95% CI: 27.6 to 35.9) individuals progressed either from normal glucose tolerance to prediabetes or T2DM, or from prediabetes to T2DM. In standardised logistic regression models controlling for age and sex, only hepatic fat attenuation (increased hepatic fat) (OR: 0.67 (95% CI: 0.55 to 0.87) per SD, visceral fat area (OR: 1.36 (95% CI: 1.06 to 1.74) per SD and hypertension (OR: 2.21 (95% CI: 1.44 to 3.40) were associated with any glycemic progression.
South Asians in the USA have a high incidence of dysglycemia. Hepatic and visceral fat may be factors in glycemic progression, and prevention efforts should target ectopic fat reduction.
南亚人2型糖尿病（T2DM）的患病率很高。这可能与疾病自然史中的高转化率有关。然而，在美国的南亚人中，关于糖尿病前期和T2DM发病率及相关预测因素的数据很少。
我们在“生活在美国的南亚人动脉粥样硬化的中介因素”研究（n = 481）中对5年随访后的糖尿病前期和T2DM发病率进行了估计，并检查了相关的关联因素。我们使用美国糖尿病协会的标准定义T2DM和糖尿病前期。糖尿病前期包括单纯空腹血糖受损（iIFG）、单纯糖耐量受损（iIGT）以及空腹血糖受损和糖耐量受损合并情况。
总体而言，152名（32%，95%置信区间：27.6至35.9）个体从正常糖耐量进展为糖尿病前期或T2DM，或从糖尿病前期进展为T2DM。在控制年龄和性别的标准化逻辑回归模型中，只有肝脏脂肪衰减（肝脏脂肪增加）（每标准差的比值比：0.67（95%置信区间：0.55至0.87））、内脏脂肪面积（每标准差的比值比：1.36（95%置信区间：1.06至1.74））和高血压（比值比：2.21（95%置信区间：1.44至3.40））与任何血糖进展相关。
美国的南亚人血糖异常的发病率很高。肝脏和内脏脂肪可能是血糖进展的因素，预防措施应针对减少异位脂肪。
