Department of Preventive Medicine, College of Korean Medicine, Dongguk University, Gyeongju 38066, Korea.
National Health Insurance Service, Wonju 26464, Korea.
Int J Environ Res Public Health. 2021 Dec 23;19(1):123. doi: 10.3390/ijerph19010123.
(1) Objective: This study examined the incidence and risk factors contributing to the progression to diabetes mellitus (DM) in a seven-year follow-up study of non-diabetic National Health Examinees. (2) Methods: For this retrospective observational cohort study, we used two national representative databases: the National Health Screening (HEALS) database 2009 and the National Health Insurance Service (NHIS) database 2009-2015. The eligible subjects without DM with blood sugar levels of <126 mg/dL were selected using the HEALS database. The subsequent follow-up and clinical outcomes were evaluated using the NHIS database. Cox proportional hazard regression was applied to examine the effects of the covariates on progression to diabetes. (3) Results: Among those who took part in the national health screening in 2009, 4,205,006 subjects who met the eligibility criteria were selected. Of these, 587,015 were diagnosed with DM during the follow-up by 2015. The incidence of progression from non-diabetes to DM was 14.0%, whereas that from impaired fasting glucose (IFG) to DM was 21.9%. Compared to the normal group, the newly diagnosed DM group was more likely to comprise older, female, currently smoking, and high-risk drinking participants and participants with IFG, hypertension, dyslipidemia, and metabolic syndrome. (4) Conclusions: This epidemiological study in the Republic of Korea found risk factors similar to those of other studies, but the incidence of progression to DM was 22.8 per 1000 person-years, which is higher than that previously reported. Hence, more care is needed to prevent DM.
(1) 目的：本研究通过对非糖尿病国家健康体检者进行为期七年的随访，探讨向糖尿病（DM）进展的发生率和相关危险因素。(2) 方法：本回顾性观察性队列研究使用了两个全国代表性数据库：2009 年国家健康筛查（HEALS）数据库和 2009-2015 年国家健康保险服务（NHIS）数据库。使用 HEALS 数据库筛选血糖<126mg/dL 的无 DM 合格受试者。使用 NHIS 数据库评估随后的随访和临床结局。采用 Cox 比例风险回归分析检验协变量对进展为糖尿病的影响。(3) 结果：在 2009 年参加国家健康筛查的人群中，选择了符合入选标准的 4205006 名受试者。其中，587015 人在随访期间（截至 2015 年）被诊断为 DM。从非糖尿病进展为 DM 的发生率为 14.0%，而从空腹血糖受损（IFG）进展为 DM 的发生率为 21.9%。与正常组相比，新诊断的 DM 组更有可能由年龄较大、女性、当前吸烟和高风险饮酒者以及 IFG、高血压、血脂异常和代谢综合征患者组成。(4) 结论：这项在大韩民国开展的流行病学研究发现了与其他研究相似的危险因素，但向 DM 进展的发生率为 22.8/1000 人年，高于以往报告的发生率。因此，需要更加注意预防 DM。
