体重变化与不同糖尿病前期表型向正常血糖水平的回归之间的关联：一项纵向队列研究的结果。

The association of body weight change and regression to normoglycemia in different phenotypes of pre-diabetes: Findings of a longitudinal cohort study.

机构信息

Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Micronutrient Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Clin Nutr ESPEN. 2024 Oct;63:887-892. doi: 10.1016/j.clnesp.2024.08.024. Epub 2024 Aug 28.

DOI:10.1016/j.clnesp.2024.08.024

PMID:39214244

Abstract

AIM

We investigated the association of a 3-year change in body weight (BW) and regression to normal glucose regulation (NGR) among different phenotypes of pre-diabetes (Pre-DM), i.e., isolated impaired glucose tolerance (iIGT), isolated impaired fasting glucose (iIFG) and combined IFG-IGT.

RESEARCH DESIGN AND METHODS

1458 Pre-DM subjects (iIFG = 618, iIGT = 462, and IFG-IGT = 378) were assessed for 3-year change-percent in BW (2006-2008 to 2009-2011) and then followed up to 2015-2017, within the national cohort of Tehran Lipid and Glucose Study (TLGS). Binary logistic regression models were used to estimate the probability (odds ratio, ORs) of regression to NGR across categories of 3-year BW change (i.e., ≥5% BW loss, <5% BW loss, BW gain) in different phenotypes of Pre-DM.

RESULTS

The mean age of the participants was 53.0 ± 13.7, and 46.8% were men. Over a median of 6 years of follow-up, the rate of regression to normoglycemia was 50.6, 43.2, and 12.7% in iIGT, iIFG, and combined IFG-IGT, respectively. The baseline-adjusted mean of 3-year BW change was not significantly different across Pre-DM phenotypes (0.68 ± 0.19, 0.32 ± 0.22, and 0.23 ± 0.24 kg, in iIFG, iIGT, and IFG-IGT). Three-year BW loss ≥5% was associated with a greater NGR probability in iIGT than other phenotypes (OR = 4.29 vs. 3.90 and 2.84 in IFG-IGT and iIFG, respectively). A modest reduction (<5% of initial BW) resulted in an increased chance of Pre-DM regression among subjects with iIGT (OR = 1.61, 95% CI = 1.03-2.52) but not iIFG or IFG-IGT phenotypes.

CONCLUSION

Short-term intensive BW loss (≥5% of initial BW) increased NGR probability in all Pre-DM phenotypes, with an order of iIGT > combined IFG-IGT > iIFG. Only iIGT takes advantage of moderate BW loss (<5% of initial BW) to increase the chance of Pre-DM regression.

摘要

目的

我们研究了体重（BW）在 3 年内的变化以及不同预糖尿病（Pre-DM）表型中恢复正常葡萄糖调节（NGR）之间的关系，即孤立性糖耐量受损（iIGT）、孤立性空腹血糖受损（iIFG）和 IFG-IGT 合并。

研究设计和方法

在德黑兰血脂和血糖研究（TLGS）的全国队列中，对 1458 例 Pre-DM 患者（iIFG=618、iIGT=462 和 IFG-IGT=378）进行了 3 年体重变化百分比（2006-2008 年至 2009-2011 年）评估，然后随访至 2015-2017 年。采用二元逻辑回归模型估计不同 Pre-DM 表型中 3 年 BW 变化（即体重减轻≥5%、体重减轻<5%、体重增加）各分类的 NGR 回归概率（比值比，ORs）。

结果

参与者的平均年龄为 53.0±13.7 岁，其中 46.8%为男性。在中位数为 6 年的随访期间，iIGT、iIFG 和 IFG-IGT 分别恢复正常血糖的比例为 50.6%、43.2%和 12.7%。在 Pre-DM 表型中，3 年 BW 变化的基线调整平均值没有显著差异（iIFG、iIGT 和 IFG-IGT 分别为 0.68±0.19、0.32±0.22 和 0.23±0.24kg）。3 年 BW 损失≥5%与 iIGT 相比，其他表型的 NGR 概率更高（OR=4.29 比 IFG-IGT 和 iIFG 分别为 3.90 和 2.84）。适度减少（初始 BW 的<5%）会增加 iIGT 患者发生 Pre-DM 回归的机会（OR=1.61，95%CI=1.03-2.52），但对 iIFG 或 IFG-IGT 表型没有影响。