Kohansal Karim, Ahmadi Nooshin, Hadaegh Farzad, Alizadeh Zeinab, Azizi Fereidoun, Habibi-Moeini Ali Siamak, Khalili Davood
Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Prim Care Diabetes. 2022 Dec;16(6):797-803. doi: 10.1016/j.pcd.2022.10.002. Epub 2022 Oct 28.
To determine the rates and predictors of the regression to normoglycemia and progression to diabetes among subjects with pre-diabetes.
A 10-year longitudinal population-based study was conducted among 1329 participants with pre-diabetes in the Tehran Lipid and Glucose Study. Pre-diabetes was divided into isolated IFG (iIFG), isolated IGT (iIGT), and combined IFG/IGT. Univariate and stepwise multivariable Cox regression was used to evaluate predictors of glycemic conversions.
The cumulative incidences of normoglycemia and diabetes were 43.7% (95%CI 40.9-46.4) and 40.1% (37.3-42.7), respectively. Isolated IGT returned to normoglycemia more than iIFG (HR:1.26, 1.05-1.51), but there was no difference in how quickly they progressed to diabetes. Regression to normoglycemia was associated with younger age, female sex, lower BMI, no familial history of diabetes, higher HDL-C, and ex-smoking. Older age, higher BMI, diastolic blood pressure, total cholesterol, lower HDL-C, and familial history for diabetes were associated with progression to diabetes. The influence of BMI on glycemic status conversions diminished with age. At approximately above 60 years old, the hazards of BMI for any conversions faded out.
The modifiable predictors of regression to normoglycemia and progression to diabetes are roughly the same. The importance of BMI attenuates in elderly subjects.
确定糖尿病前期患者血糖恢复正常及进展为糖尿病的发生率和预测因素。
在德黑兰血脂与血糖研究中，对1329例糖尿病前期参与者进行了一项为期10年的基于人群的纵向研究。糖尿病前期分为单纯空腹血糖受损（iIFG）、单纯糖耐量受损（iIGT）和空腹血糖受损/糖耐量受损合并存在（IFG/IGT）。采用单因素和逐步多变量Cox回归评估血糖转化的预测因素。
血糖恢复正常和糖尿病的累积发生率分别为43.7%（95%CI 40.9 - 46.4）和40.1%（37.3 - 42.7）。单纯IGT恢复正常血糖的比例高于iIFG（HR：1.26，1.05 - 1.51），但进展为糖尿病的速度没有差异。血糖恢复正常与年龄较小、女性、BMI较低、无糖尿病家族史、HDL-C较高及既往吸烟有关。年龄较大、BMI较高、舒张压、总胆固醇、HDL-C较低及糖尿病家族史与进展为糖尿病有关。BMI对血糖状态转化的影响随年龄增长而减弱。在大约60岁以上时，BMI对任何转化的风险消失。
血糖恢复正常和进展为糖尿病的可改变预测因素大致相同。BMI在老年受试者中的重要性减弱。
