Department of Ultrasound, The Fourth Hospital of China Medical University, Shenyang, Liaoning, China.
Institute of Preventive Medicine, China Medical University, Shenyang, Liaoning, China.
BMC Public Health. 2024 Feb 15;24(1):475. doi: 10.1186/s12889-024-17996-y.
To evaluate the current prevalence of prediabetes in northeast China, and further determine the association between prediabetes alone or coexistent with hypertension and cardiovascular disease (CVD) mortality.
In the prospective study, 15,557 participants without diabetes among aged ≥40 years in northeast China, were followed for a median of 5.5 years. Following the American Diabetes Association, prediabetes was defined as fasting plasma glucose (FPG) range of 5.6-6.9 mmol/L or glycated hemoglobin (HbA1c) range of 5.7-6.4% in people without diabetes.
The prevalence of prediabetes was 44.3% among population aged ≥40 years in northeast China. Prediabetes alone did not promote risk of CVD mortality. However, when the subgroups were stratified by hypertension, the CVD mortality risk in prediabetes plus hypertension subjects increased significantly compared with population without prediabetes and hypertension. Multivariate-adjusted hazard ratios for CVD mortality in prediabetes subgroups plus hypertension were 2.28 (95% CI: 1.50, 3.47) for those diagnosed by FPG < 5.6 mmol/L & HbA1c 5.7-6.4%, 2.18 (95% CI: 1.53, 3.10) for those diagnosed by FPG 5.6-6.0 mmol/L & HbA1c < 6.5% and 2.35 (95% CI: 1.65, 3.35) for those diagnosed by FPG 6.1-6.9 & HbA1c < 6.5% compared with the reference group. Moreover, the percentage of hypertension in prediabetes subjects was high (60.4%), but the awareness, treatment and control rates were far from satisfactory (45.3, 35.1 and 4.8%, respectively).
The prevalence of prediabetes remains high in northeast China, and the CVD mortality was elevated significantly in prediabetes coexistent with hypertension. Considering the high percentage and low control rate of hypertension in prediabetes, strategies focused on HbA1c screening, FPG lowering and blood pressure management should be emphasized in northeast China.
评估中国东北地区目前的糖尿病前期患病率，并进一步确定糖尿病前期单独或与高血压并存与心血管疾病（CVD）死亡率之间的关系。
在这项前瞻性研究中，纳入了年龄≥40 岁、无糖尿病的 15557 名参与者，中位随访时间为 5.5 年。根据美国糖尿病协会的定义，糖尿病前期是指空腹血糖（FPG）在 5.6-6.9mmol/L 或糖化血红蛋白（HbA1c）在 5.7-6.4%的无糖尿病人群。
中国东北地区≥40 岁人群的糖尿病前期患病率为 44.3%。糖尿病前期本身不会增加 CVD 死亡率的风险。然而，当按高血压分层亚组时，与无糖尿病和高血压人群相比，糖尿病前期合并高血压患者的 CVD 死亡率风险显著增加。糖尿病前期亚组合并高血压的 CVD 死亡率的多变量调整后危险比分别为：FPG<5.6mmol/L 且 HbA1c 为 5.7-6.4%的患者为 2.28（95%CI：1.50，3.47）；FPG 为 5.6-6.0mmol/L 且 HbA1c<6.5%的患者为 2.18（95%CI：1.53，3.10）；FPG 为 6.1-6.9mmol/L 且 HbA1c<6.5%的患者为 2.35（95%CI：1.65，3.35），与参考组相比。此外，糖尿病前期患者中高血压的比例较高（60.4%），但知晓率、治疗率和控制率均远不理想（分别为 45.3%、35.1%和 4.8%）。
中国东北地区的糖尿病前期患病率仍然很高，糖尿病前期合并高血压患者的 CVD 死亡率显著升高。考虑到糖尿病前期中高血压的高比例和低控制率，应在中国东北地区强调以 HbA1c 筛查、FPG 降低和血压管理为重点的策略。
