累积的空腹血糖受损暴露与 2 型糖尿病的未来风险。
Cumulative exposure to impaired fasting glucose and future risk of type 2 diabetes mellitus.
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, South Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, South Korea.
出版信息
Diabetes Res Clin Pract. 2021 May;175:108799. doi: 10.1016/j.diabres.2021.108799. Epub 2021 Apr 15.
AIMS
The status of metabolic abnormalities including impaired fasting glucose (IFG) can change over time, yet little is known about how exposure duration to IFG is related to diabetes risk.
METHODS
Using nationally representative data from the Korean National Health Insurance system, 2,513,127 people who were free of diabetes and who received four consecutive annual health examinations commencing in 2006 or 2007 were followed up at the end of 2016. IFG was defined as fasting blood glucose levels of 100-125 mg/dL. Participants were classified numerically according to the cumulative number of IFG diagnoses.
RESULTS
Over 4 years, 53% of the population participants remained normoglycemic, while 3% had persistent IFG and 44% had intermittent IFG. The risk of type 2 diabetes mellitus (DM) increased gradually with increasing IFG exposure score. Subjects with an IFG exposure score of 2, 3, or 4 had a 3.75- to 9.77-fold increased hazard ratio (HR) for incident diabetes (IFG exposure score 0 reference; score 2, HR 3.75, 95% confidence interval [CI] 3.67-3.83; score 3, HR 6.21, 95% CI 6.08-6.36; score 4, HR 9.77, 95% CI 9.53-10.02).
CONCLUSIONS
Cumulative IFG exposure was associated with a higher risk of type 2 DM in a dose-response fashion.
目的
代谢异常的状况，包括空腹血糖受损（IFG），可能会随时间而改变，但对于 IFG 的暴露时间与糖尿病风险之间的关系，我们知之甚少。
方法
利用韩国国家健康保险系统的全国代表性数据，对 2006 年或 2007 年开始接受连续 4 次年度健康检查且无糖尿病的 2513127 人进行随访，随访至 2016 年底。IFG 定义为空腹血糖水平为 100-125mg/dL。根据 IFG 诊断的累计次数，参与者按数值进行分类。
结果
在 4 年内，53%的人群参与者保持血糖正常，3%的人持续存在 IFG，44%的人间歇性出现 IFG。随着 IFG 暴露评分的增加，2 型糖尿病（DM）的风险逐渐增加。IFG 暴露评分分别为 2、3 或 4 的受试者发生糖尿病的风险比（HR）分别为 3.75 至 9.77 倍（IFG 暴露评分 0 为参考；评分 2，HR 3.75，95%置信区间 [CI]3.67-3.83；评分 3，HR 6.21，95% CI 6.08-6.36；评分 4，HR 9.77，95% CI 9.53-10.02）。
结论
累积 IFG 暴露与 2 型 DM 风险呈剂量反应关系。
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