Florida International University, Miami, FL.
Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston Salem, NC.
Ethn Dis. 2022 Jul 21;32(3):203-212. doi: 10.18865/ed.32.3.203. eCollection 2022 Summer.
Diabetes and prediabetes are common among African Americans (AA), but the frequency and predictors of transition between normal, impaired glucose metabolism, and diabetes are not well-described. The aim of this study was to examine glucometabolic transitions and their association with the development of type 2 diabetes (T2D).
AA participants of the Jackson Heart Study who attended baseline exam (2000-2004) and at least one of two subsequent exams (2005-2008 and 2009-2013, ~8 years) were classified according to glycemic status. Transitions were defined as progression (deterioration) or remission (improvement) of glycemic status. Multinomial logistic regression models with repeated measures were used to estimate the odds ratios (OR) for remission and progression with adjustment for demographic, anthropometric, behavioral, and biochemical factors.
Among 3353 participants, (mean age 54.6±12.3 years), 43% were normoglycemic, 32% were prediabetes, and 25% had diabetes at baseline. For those with normal glucose at a visit, the probability at the next visit (~4years) of having prediabetes or diabetes was 38.5% and 1.8%, respectively. For those with prediabetes, the probability was 9.9% to improve to normal and 19.9% to progress to diabetes. Progression was associated with baseline BMI, diabetes status, triglycerides, family history of diabetes, and weight gain (OR 1.04 kg, 95% CI:1.03-1.06, P=<.0001). Remission was strongly associated with weight loss (OR .97 kg, 95%CI: .95-.98, P<.001).
In AAs, glucometabolic transitions were frequent and most involved deterioration. From a public health perspective additional emphasis should be placed on weight control to preserve glucometabolic status and prevent progression to T2D.
糖尿病和糖尿病前期在非裔美国人（AA）中很常见，但正常、糖代谢受损和糖尿病之间的转变频率及其预测因素尚不清楚。本研究旨在检查糖代谢的转变及其与 2 型糖尿病（T2D）发展的关系。
参加 Jackson 心脏研究的 AA 参与者在基线检查（2000-2004 年）和至少两次后续检查（2005-2008 年和 2009-2013 年，约 8 年）中进行了分类，根据血糖状态进行分类。转变定义为血糖状态的进展（恶化）或缓解（改善）。使用重复测量的多变量逻辑回归模型，调整人口统计学、人体测量学、行为和生化因素，估计缓解和进展的优势比（OR）。
在 3353 名参与者中（平均年龄 54.6±12.3 岁），43%的人血糖正常，32%的人处于糖尿病前期，25%的人在基线时有糖尿病。对于那些在一次就诊时血糖正常的人，在下一次就诊（约 4 年后）时患有糖尿病前期或糖尿病的概率分别为 38.5%和 1.8%。对于那些有糖尿病前期的人，改善到正常的概率为 9.9%，进展为糖尿病的概率为 19.9%。进展与基线 BMI、糖尿病状态、甘油三酯、糖尿病家族史和体重增加有关（OR 1.04kg，95%CI：1.03-1.06，P<0.0001）。缓解与体重减轻密切相关（OR.97kg，95%CI：.95-.98，P<.001）。
在 AA 中，糖代谢的转变很常见，而且大多数是恶化。从公共卫生的角度来看，应该更加重视体重控制，以保持糖代谢状态并防止进展为 T2D。
