Prevalence of prediabetes and association with cardiometabolic and renal factors. SIMETAP-PRED study

Introduction

Prediabetes is a major public health problem. The aims of the SIMETAP-PRED study were to determine the prevalence rates of prediabetes according to two diagnostic criteria, and to compare the association of cardiometabolic and renal risk factors between populations with and without prediabetes.

Methods

Cross-sectional observational study conducted in Primary Care. Based random sample: 6588 study subjects (response rate: 66%). Two diagnostic criteria for prediabetes were used: 1. Prediabetes according to the Spanish Diabetes Society (PRED-SDS): Fasting plasma glucose (FPG) 110–125 mg/dL or HbA1c 6.0%–6.4%; 2. Prediabetes according to the American Diabetes Association (PRED-ADA): FPG 100–125 mg/dL or HbA1c 5.7%–6.4%. The crude and sex- and age-adjusted prevalence rates, and cardiometabolic and renal variables associated with prediabetes were assessed.

Results

The crude prevalence rates of PRED-SDS and PRED-ADA were 7.9% (95%CI 7.3–8.6%), and 22.0% (95%CI 21.0%–23.0%) respectively, their age-adjusted prevalence rates were 6.6% and 19.1 respectively. The high or very high cardiovascular risk (CVR) of the PRED-SDS or PRED-ADA populations were 68.6% (95%CI 64.5%–72.6%) and 61.7% (95%CI 59.1%–64.1%) respectively. Hypertension, hypertriglyceridemia, overweight, obesity, and increased waist-to-height ratio were independently associated with PRED-SDS. In addition to these factors, low glomerular filtration rate and hypercholesterolemia were also independently associated with PRED-ADA.

Conclusions

The prevalence of PRED-ADA triples that of PRED-SDS. Two thirds of the population with prediabetes had a high CVR. Several cardiometabolic and renal risk factors were associated with prediabetes. Compared to the SDS criteria, the ADA criteria make the diagnosis of prediabetes easier.