The Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan.
Department of Rehabilitation Science, Graduate School of Medical Sciences, Kitasato University, Kanagawa 252-0373, Japan.
J Clin Endocrinol Metab. 2022 Jun 16;107(7):1843-1853. doi: 10.1210/clinem/dgac247.
The natural history of young adults with prediabetes and its association with cardiovascular health (CVH) metrics in progression to diabetes remain unknown.
We examined the association between CVH metrics and the annual incidence of diabetes in young adults with prediabetes.
This observational cohort study used the JMDC Claims Database. We analyzed 18 908 participants aged 18 to 44 years, with available fasting plasma glucose (FPG) data for 5 consecutive years, and who had prediabetes (FPG 100-125 mg/dL) at the initial health checkup. The ideal CVH metrics were as follows: nonsmoking, body mass index (BMI) less than 25 kg/m2, physical activity at goal, optimal dietary habits, blood pressure less than 120/80 mm Hg, and total cholesterol less than 200 mg/dL. We analyzed the association between CVH metrics and the annual incidence of diabetes. We also examined the relationship between 1-year changes in CVH metrics and the subsequent risk of diabetes.
The incidence of diabetes was 3.3% at 1 year and 9.5% at 5 years after the initial health checkup. An increasing number of nonideal CVH metrics have been associated with an increased risk of diabetes. Nonideal BMI, smoking, blood pressure, and total cholesterol level were associated with an increased risk of diabetes. This association was observed both in men and women. A one-point increase in the number of nonideal CVH metric components was associated over 1 year with an increased risk of diabetes.
CVH metrics can stratify the risk of diabetes in young adults with prediabetes. Improving CVH metrics may reduce the risk of developing diabetes.
年轻人糖尿病前期的自然史及其与心血管健康（CVH）指标向糖尿病进展的关系尚不清楚。
我们研究了 CVH 指标与年轻糖尿病前期患者糖尿病年度发病率之间的关系。
这项观察性队列研究使用了 JMDC 理赔数据库。我们分析了 18908 名年龄在 18 至 44 岁、在初始健康检查时有 5 年连续空腹血糖（FPG）数据且患有糖尿病前期（FPG 100-125mg/dL）的参与者。理想的 CVH 指标如下：不吸烟、体重指数（BMI）<25kg/m2、达到目标的身体活动、最佳饮食习惯、血压<120/80mmHg 和总胆固醇<200mg/dL。我们分析了 CVH 指标与糖尿病年度发病率之间的关系。我们还检查了 CVH 指标 1 年内变化与随后糖尿病风险之间的关系。
在初始健康检查后 1 年和 5 年，糖尿病的发病率分别为 3.3%和 9.5%。非理想 CVH 指标数量的增加与糖尿病风险的增加相关。非理想 BMI、吸烟、血压和总胆固醇水平与糖尿病风险增加相关。这种关联在男性和女性中均可见。在 1 年内，非理想 CVH 指标成分数量每增加一个点，与糖尿病风险增加相关。
CVH 指标可对糖尿病前期的年轻人进行糖尿病风险分层。改善 CVH 指标可能降低发生糖尿病的风险。
