Tangjittipokin Watip, Srisawat Lanraphat, Teerawattanapong Nipaporn, Narkdontri Tassanee, Homsanit Mayuree, Plengvidhya Nattachet
Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Siriraj Center of Research Excellence for Diabetes and Obesity (SiCORE-DO), Faculty of Medicine Siriraj, Mahidol University, Bangkok, Thailand.
J Multidiscip Healthc. 2022 Jul 23;15:1585-1594. doi: 10.2147/JMDH.S374164. eCollection 2022.
This study investigated the prevalence and characteristics of prediabetes (PreDM) and metabolic syndrome (MetS) in seemingly healthy persons attending a health check-up clinic at a tertiary care hospital.
This was a cross-sectional study that enrolled 1213 subjects (339 male, 874 female) who underwent an annual health check-up at Siriraj Hospital, Bangkok, Thailand from 2009 to 2019. Factors that independently related to PreDM were analyzed using unconditional logistic regression analysis with adjustments for age, BMI, and gender.
The prevalence of PreDM and MetS was 54.3% and 19.7% respectively. Participants with impaired fasting glucose (IFG) and glycated hemoglobin (HbA) 38.8-46.4 mmol/mol had significantly higher waist circumference (WC) and blood pressure (BP) compared to those with IFG or HbA 38.8-46.4 mmol/mol alone ( < 0.05). Among three PreDM subgroups, the average age was lowest in the HbA 38.8-46.4 mmol/mol subgroup ( < 0.001). PreDM participants with MetS were older ( = 0.03), had higher WC, BP, fasting plasma glucose and serum triglyceride level (all < 0.001) but had lower serum high-density lipoprotein (HDL) cholesterol level ( < 0.001). Multivariate analysis revealed high MetS score, obesity, and low serum HDL cholesterol level to be independently associated with PreDM with odds ratios of 9.02 (95% confidence interval [CI]: 4.03-20.18), 1.8 (95% CI: 1.07-3.04), and 1.42 (95% CI: 1.02-1.96), respectively.
The prevalence of PreDM and MetS was relatively high in seemingly healthy persons. Distinct PreDM subgroups with or without MetS exhibited diverse clinical and biochemical features suggesting dissimilar pathogenesis.
本研究调查了在一家三级护理医院的健康体检诊所进行体检的看似健康的人群中糖尿病前期（PreDM）和代谢综合征（MetS）的患病率及特征。
这是一项横断面研究，纳入了2009年至2019年期间在泰国曼谷诗里拉吉医院接受年度健康体检的1213名受试者（男性339名，女性874名）。使用无条件逻辑回归分析对与糖尿病前期独立相关的因素进行分析，并对年龄、体重指数（BMI）和性别进行了调整。
糖尿病前期和代谢综合征的患病率分别为54.3%和19.7%。空腹血糖受损（IFG）且糖化血红蛋白（HbA）为38.8 - 46.4 mmol/mol的参与者，其腰围（WC）和血压（BP）显著高于仅患有IFG或HbA为38.8 - 46.4 mmol/mol的参与者（P < 0.05）。在三个糖尿病前期亚组中，HbA为38.8 - 46.4 mmol/mol亚组的平均年龄最低（P < 0.001）。患有代谢综合征的糖尿病前期参与者年龄更大（P = 0.03），腰围、血压、空腹血糖和血清甘油三酯水平更高（均P < 0.001），但血清高密度脂蛋白（HDL）胆固醇水平更低（P < 0.001）。多变量分析显示，高代谢综合征评分、肥胖和低血清HDL胆固醇水平与糖尿病前期独立相关，比值比分别为9.02（95%置信区间[CI]：4.03 - 20.18）、1.8（95% CI：1.07 - 3.04）和1.42（95% CI：1.02 - 1.96）。
在看似健康的人群中，糖尿病前期和代谢综合征的患病率相对较高。有或没有代谢综合征的不同糖尿病前期亚组表现出不同的临床和生化特征，提示发病机制不同。
