空腹血糖变化与中国非糖尿病队列中糖尿病发病的非线性关联。
Nonlinear association between changes in fasting plasma glucose and the incidence of diabetes in a nondiabetic Chinese cohort.
机构信息
Department of Endocrinology, Bishan Hospital of Chongqing, Bishan Hospital of Chongqing Medical University, Bishan, Chongqing, 402760, China.
Taihe Hospital, Postgraduate Training Basement of Jinzhou Medical University, Hubei University of Medical, Shiyan, 442400, China.
出版信息
BMC Endocr Disord. 2022 Jul 27;22(1):191. doi: 10.1186/s12902-022-01094-4.
BACKGROUND
Limited data show that changes in fasting plasma glucose (FPG changes) are related to the incidence of type 2 diabetes (T2D). We aimed to correlate FPG changes with incident diabetes and evaluate FPG changes as a marker to screen participants at high risk of T2D in China.
METHODS
A total of 116,816 individuals were followed during a median follow-up of 3.10 years by secondary analysis in a nondiabetic Chinese cohort. The turning points were derived from a receiver operating characteristic curve. Hazard ratios (HRs) were evaluated by Cox proportional hazards models.
RESULTS
A total of 2669 cases of T2D were identified (788 women and 1881 men). The age-standardized incidence of diabetes was 12.87 per 1000 person-years (women: 11.04; men: 14.69). A nonlinear relationship between FPG changes and incident diabetes is shown by the fitting curves. The curves were categorized into three stages by two turning points (-0.04 and 1.25 mmol/L) and conformed to the hook-like pattern: an initial decrease (stage-1), then a transient sharp elevation (stage-2), followed by a slow increase (stage-3). HRs per SD of FPG changes on incident diabetes varied with stage: stage-1: 0.16 (0.12, 0.23), stage-2: 0.20 (0.15, 0.28) and stage-3: 0.22 (0.16, 0.31). Compared with stage-1, the HR in stage-3 was significantly higher at 28.05 (23.99, 32.79), while the increase in stage-2 was slight at 2.16 (1.79, 2.61), and the HR in stage-3 rose to 30.09 (25.02, 36.19).
CONCLUSIONS
FPG changes had a strong correlation with the incidence of T2D and was a steady indicator that was used to distinguish the participants at high risk of diabetes.
背景
有限的数据表明，空腹血糖（FPG）的变化与 2 型糖尿病（T2D）的发病有关。我们旨在将 FPG 变化与糖尿病发病相关联，并评估 FPG 变化作为中国 T2D 高危人群筛查的标志物。
方法
通过对一个非糖尿病中国队列的二次分析，共纳入 116816 名参与者，中位随访时间为 3.10 年。转折点由受试者工作特征曲线得出。采用 Cox 比例风险模型评估风险比（HR）。
结果
共确定了 2669 例 T2D 病例（女性 788 例，男性 1881 例）。糖尿病的年龄标准化发病率为 12.87/1000 人年（女性为 11.04/1000 人年，男性为 14.69/1000 人年）。拟合曲线显示 FPG 变化与糖尿病发病之间呈非线性关系。根据两个转折点（-0.04 和 1.25mmol/L），曲线分为三个阶段，符合钩状模式：初始下降（阶段 1），然后短暂急剧升高（阶段 2），随后缓慢升高（阶段 3）。FPG 变化每标准差的 HR 与阶段有关：阶段 1：0.16（0.12，0.23），阶段 2：0.20（0.15，0.28），阶段 3：0.22（0.16，0.31）。与阶段 1 相比，阶段 3 的 HR 显著升高，为 28.05（23.99，32.79），而阶段 2 的升高幅度较小，为 2.16（1.79，2.61），阶段 3 的 HR 升高至 30.09（25.02，36.19）。
结论
FPG 变化与 T2D 的发病密切相关，是一种稳定的指标，可用于区分糖尿病高危人群。
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