Risk and population attributable fraction of metabolic syndrome and impaired fasting glucose for the incidence of type 2 diabetes mellitus among middle-aged Japanese individuals: Aichi Worker's Cohort Study
Risk and population attributable fraction of metabolic syndrome and impaired fasting glucose for the incidence of type 2 diabetes mellitus among middle-aged Japanese individuals: Aichi Worker's Cohort Study
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DOI：
10.1111/jdi.13230
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发表时间：
2020-03-03
影响因子：
3.2
通讯作者：
Aoyama, Atsuko
中科院分区：
文献类型：
--
作者：
Kaneko, Kayo;Yatsuya, Hiroshi;Aoyama, Atsuko
日本政府于2008年启动了一项全国性的代谢综合征（MetS）筛查计划，以预防心血管疾病和糖尿病。尽管空腹血糖受损（IFG）是2型糖尿病的一个强有力的预测因子，但该项目并未对非MetS个体的IFG进行随访。本研究旨在探讨风险和人口归因分数（PAF）的MetS和IFG的发病率为2型diabetesmellitus.Materials和方法日本工人（3,417名男性和714名女性）年龄40-64岁，没有糖尿病史的前瞻性随访。MetS被定义为腹部肥胖加上两个或更多代谢危险因素，或者在腰围正常的情况下超重加上三个或更多代谢危险因素。IFG定义为空腹血糖100-125 mg/dL。结果240例2型糖尿病患者平均随访6.3年。与无MetS和IFG者相比，非MetS伴IFG者、MetS不伴IFG者和MetS伴IFG者患2型糖尿病的多变量校正风险比（95%置信区间）分别为4.9（3.4-7.1）、2.4（1.6-3.5）和8.3（5.9-11.5）。相应的PAF为2型糖尿病的发病率分别为15.6，9.1和29.7%，respectively。结论IFG代表了更高的风险和PAF比代谢综合征2型糖尿病的发病率在中年日本人。MetS和IFG共存者发生2型糖尿病的危险性最高，PAF最高。应重新考虑目前日本MetS筛查计划，以随访IFG非MetS个体。
Aims/Introduction The Japanese government started a nationwide screening program for metabolic syndrome (MetS) to prevent cardiovascular diseases and diabetes in 2008. Although impaired fasting glucose (IFG) is a strong predictor for type 2 diabetes mellitus, the program does not follow up IFG in non-MetS individuals. This study aimed to examine the risk and the population attributable fraction (PAF) of MetS and IFG for incidence of type 2 diabetes mellitus.Materials and Methods Japanese workers (3,417 men and 714 women) aged 40-64 years without a history of diabetes were prospectively followed. MetS was defined as either abdominal obesity plus two or more metabolic risk factors, or being overweight in the case of normal waist circumference plus three or more metabolic risk factors. IFG was defined as fasting blood glucose 100-125 mg/dL.Results During a mean 6.3 years, 240 type 2 diabetes mellitus cases were identified. Compared with those without MetS and IFG, the multivariable-adjusted hazard ratios (95% confidence interval) of non-MetS individuals with IFG, MetS individuals without IFG and MetS individuals with IFG for type 2 diabetes mellitus were 4.9 (3.4-7.1), 2.4 (1.6-3.5) and 8.3 (5.9-11.5), respectively. The corresponding PAFs for type 2 diabetes mellitus incidence were 15.6, 9.1 and 29.7%, respectively.Conclusions IFG represented a higher risk and PAF than MetS for type 2 diabetes mellitus incidence in middle-aged Japanese individuals. The coexistence of MetS and IFG showed the highest risk and PAF for type 2 diabetes mellitus incidence. The current Japanese MetS screening program should be reconsidered to follow up non-MetS individuals with IFG.