Prediabetes Phenotypes and All-Cause or Cardiovascular Mortality: Evidence from a Population-Based Study.

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Practice Pub Date : 2025-01-19 DOI:10.1016/j.eprac.2025.01.003

Xiufang Kong, Wei Wang

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引用次数: 0

Abstract

Objectives: Fasting plasma glucose (FPG), glycated hemoglobin A_1C (HbA_1C), and 2-hour post-load plasma glucose (2h PG) are all currently used to define prediabetes. We aimed to determine whether a higher number of prediabetes defects corresponds to an increased all-cause and cardiovascular disease (CVD) mortality.

Methods: Individuals with prediabetes and available information on FPG, HbA_1C, 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.

Results: Among the 4511 individuals included, 76.31%, 30.89%, and 41.65% met the FPG-, 2h PG-, and HbA_1C-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.

Conclusions: A higher number of diagnostic criteria for prediabetes was associated with increased all-cause and CVD mortality.

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前驱糖尿病表型与全因或心血管死亡率：来自人群研究的证据

目的：空腹血糖（FPG）、糖化血红蛋白（HbA1C）和负荷后2小时血浆血糖（2h PG）目前都被用来定义前驱糖尿病。我们的目的是确定较高数量的前驱糖尿病缺陷是否与增加的全因和心血管疾病（CVD）死亡率相对应。方法：糖尿病前期患者的FPG、HbA1C、2h PG和死亡率数据来源于2005 - 2016年全国健康与营养检查调查。Kaplan-Meier生存曲线、Cox比例风险回归分析和分层分析用于比较有一个、两个和全部三个缺陷的参与者的全因死亡率和CVD死亡率。结果：在纳入的4511人中，分别有76.31%、30.89%和41.65%符合FPG-、2h PG-和hba1c定义的前驱糖尿病标准。分别有2609名（60.78%）、1420名（29.60%）和482名（9.62%）成年人符合前驱糖尿病的一项、两项和全部三项标准。在中位随访100个月期间，共发生534例（180例心血管疾病相关）死亡。满足2项和3项标准的全因死亡率（P趋势= 0.006）和CVD死亡率（P趋势= 0.002）的多变量校正风险比分别为1.341（1.042-1.727）和1.369(1.027-1.824)，满足1项标准的全因死亡率（P趋势= 0.002）的多变量校正风险比和95%置信区间分别为1.836（1.228-2.744）和2.037（1.092-3.801）。在亚组分析中，仅在男性中观察到前驱糖尿病诊断标准数量与CVD死亡率之间的关联。结论：较高的前驱糖尿病诊断标准与全因死亡率和心血管疾病死亡率增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.