Kong Xiufang, Wang Wei
Department of Rheumatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Nephrology, Shanghai Tenth People's Hospital, Shanghai, China.
Endocr Pract. 2025 Apr;31(4):486-493. doi: 10.1016/j.eprac.2025.01.003. Epub 2025 Jan 19.
Fasting plasma glucose (FPG), glycated hemoglobin A (HbA), and 2-hour postload plasma glucose (2h PG) are all currently used to define prediabetes. We aimed to determine whether a higher number of prediabetes defects correspond to an increased all-cause and cardiovascular disease (CVD) mortality.
Individuals with prediabetes and available information on FPG, HbA, 2h PG, and mortality data were derived from the 2005-2016 National Health and Nutrition Examination Survey. Kaplan-Meier survival curves, Cox proportional hazards regression analysis, and stratified analysis were used to compare all-cause and CVD mortality among participants with one, two, and all three defects.
Among the 4511 individuals included, 76.31%, 30.89%, and 41.65% met the FPG-, 2h PG-, and HbA-defined criteria for prediabetes, respectively. There were 2609 (60.78%), 1420 (29.60%), and 482 (9.62%) adults meeting one, two, and all three criteria for prediabetes, respectively. During a median follow-up of 100 months, a total of 534 (180 CVD-related) deaths occurred. The multivariable-adjusted hazard ratios and 95% confidence intervals in those meeting two and three criteria were 1.341 (1.042-1.727) and 1.369 (1.027-1.824), respectively, for all-cause mortality (P for trend = 0.006), and 1.836 (1.228-2.744) and 2.037 (1.092-3.801), respectively, for CVD mortality (P for trend = 0.002), with those meeting only one criterion as the reference. In subgroup analysis, the association between the number of diagnostic criteria for prediabetes and CVD mortality was observed only in men.
A higher number of diagnostic criteria for prediabetes was associated with increased all-cause and CVD mortality.
空腹血糖（FPG）、糖化血红蛋白A（HbA）和餐后2小时血糖（2h PG）目前均用于定义糖尿病前期。我们旨在确定糖尿病前期缺陷数量增加是否与全因死亡率和心血管疾病（CVD）死亡率升高相关。
患有糖尿病前期且有FPG、HbA、2h PG和死亡率数据的个体来自2005 - 2016年国家健康与营养检查调查。采用Kaplan - Meier生存曲线、Cox比例风险回归分析和分层分析来比较有1项、2项和所有3项缺陷的参与者的全因死亡率和CVD死亡率。
在纳入的4511名个体中，分别有76.31%、30.89%和41.65%符合FPG、2h PG和HbA定义的糖尿病前期标准。分别有2609名（60.78%）、1420名（29.60%）和482名（9.62%）成年人符合1项、2项和所有3项糖尿病前期标准。在中位随访100个月期间，共发生534例（180例与CVD相关）死亡。对于全因死亡率，符合2项和3项标准者的多变量调整风险比及95%置信区间分别为1.341（1.042 - 1.727）和1.369（1.027 - 1.824）（趋势P值 = 0.006）；对于CVD死亡率，分别为1.836（1.228 - 2.744）和2.037（1.092 - 3.801）（趋势P值 = 0.002），以仅符合1项标准者作为参照。在亚组分析中，仅在男性中观察到糖尿病前期诊断标准数量与CVD死亡率之间的关联。
糖尿病前期诊断标准数量增加与全因死亡率和CVD死亡率升高相关。
