Regression from prediabetes to normal glucose levels is more frequent than progression towards diabetes: The CRONICAS Cohort Study
Regression from prediabetes to normal glucose levels is more frequent than progression towards diabetes: The CRONICAS Cohort Study
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DOI：
10.1016/j.diabres.2019.107829
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发表时间：
2020-05-01
影响因子：
5.1
通讯作者：
Jaime Miranda, J.
中科院分区：
文献类型：
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作者：
Lazo-Porras, Maria;Bernabe-Ortiz, Antonio;Jaime Miranda, J.
目的：本研究旨在(1)根据不同的定义估计糖尿病前期的患病率，(2)评估向正常血糖水平的回归和向T2 DM的进展，以及(3)在一个拉丁美洲国家的四个不同地理环境中确定与回归和进展相关的因素。2010年9月开始招生，2013年开展后续工作。根据世界卫生组织(WHO)、美国糖尿病协会(ADA)和国家健康与护理卓越研究所(NICE)的定义确定糖尿病前期、T2 DM和正常血糖水平。主要结果是血糖恢复到正常水平和T2 DM的发生率。计算了患病率估计值和95%可信区间(95%CI)。结果：基线时糖尿病前期患病率按WHO、ADA和NICE标准分别为6.5%(95%CI 5.6~7.6%)、53.6%(95%CI 51.6~55.6%)和24.6%(95%CI 22.8~26.4%)。经过2.2年的随访，糖尿病前期患者的血糖恢复到正常血糖的累积发生率为31.4%~68.9%，而T2 DM的发生率为5.5%~28.8%。年龄、体重指数和胰岛素抵抗与血糖恢复正常和糖尿病进展相关。结论：从糖尿病前期回归到正常血糖比进展为糖尿病更常见。(C)2019爱思唯尔B.V.保留所有权利。
Aims: This study aimed to (1) estimate the prevalence of prediabetes according to different definitions, (2) evaluate regression to normal glucose levels and progression towards T2DM, and (3) determine factors associated with regression and progression across four diverse geographical settings in a Latin American country.Methods: The CRONICAS Cohort Study was conducted in four different areas in Peru. Enrollment started in September 2010 and follow-up was conducted in 2013. Prediabetes, T2DM and normal glucose levels were determined according to definitions from the World Health Organization (WHO), American Diabetes Association (ADA), and National Institute for Health and Care Excellence (NICE). The main outcomes were regression to normal glucose levels and incidence of T2DM. Prevalence estimates and 95% confidence intervals (95% CI) were calculated. Crude and adjusted models using Poisson regression were performed and relative risk ratios (RRR) and 95% CI were calculated.Results: At baseline, the prevalence of prediabetes varied markedly by definition used: 6.5% (95% CI 5.6-7.6%), 53.6% (95% CI 51.6-55.6%), and 24.6% (95% CI 22.8-26.4%) according to WHO, ADA and NICE criteria, respectively. After 2.2 years of follow-up, in those with prediabetes, the cumulative incidence of regression to euglycemia ranged between 31.4% and 68.9%, whereas the incidence of T2DM varied from 5.5% to 28.8%. Factors associated with regression to normal glucose levels and progression to diabetes were age, body mass index, and insulin resistance.Conclusions: Regression from pre-diabetes back to euglycemia was much more common than progression to diabetes. (C) 2019 Elsevier B.V. All rights reserved.