Prediabetes: a high-risk state for diabetes development.
Prediabetes: a high-risk state for diabetes development.
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DOI：
10.1016/s0140-6736(12)60283-9
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发表时间：
2012-06-16
期刊：
影响因子：
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通讯作者：
Kivimäki M
中科院分区：
文献类型：
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作者：
Tabák AG;Herder C;Rathmann W;Brunner EJ;Kivimäki M
基于高于正常但低于糖尿病阈值的血糖参数，前驱糖尿病（或“中度高血糖症”）是糖尿病的高风险状态，年转化率为5%-10%;转化回正常血糖的比例相似。前驱糖尿病的患病率在全球范围内不断增加，预计2030年将有> 4.7亿人患有前驱糖尿病。前驱糖尿病与胰岛素抵抗和β细胞功能障碍的同时存在相关，这些异常在葡萄糖变化可检测之前开始。观察证据显示糖尿病前期与早期肾病、慢性肾病、小纤维神经病变、糖尿病视网膜病变和大血管疾病风险增加相关。多因素风险评分可以使用非侵入性参数和血液代谢特征以及血糖值来优化糖尿病风险的估计。对于糖尿病前期个体，生活方式的改变是糖尿病预防的基石，有证据表明相对风险降低40%-70%。积累的数据也表明药物治疗的潜在益处。
Prediabetes (or “intermediate hyperglycaemia”), based on glycaemic parameters above normal but below diabetes thresholds is a high risk state for diabetes with an annualized conversion rate of 5%–10%; with similar proportion converting back to normoglycaemia. The prevalence of prediabetes is increasing worldwide and it is projected that >470 million people will have prediabetes in 2030. Prediabetes is associated with the simultaneous presence of insulin resistance and β-cell dysfunction, abnormalities that start before glucose changes are detectable. Observational evidence shows associations of prediabetes with early forms of nephropathy, chronic kidney disease, small fibre neuropathy, diabetic retinopathy, and increased risk of macrovascular disease. Multifactorial risk scores could optimize the estimation of diabetes risk using non-invasive parameters and blood-based metabolic traits in addition to glycaemic values. For prediabetic individuals, lifestyle modification is the cornerstone of diabetes prevention with evidence of a 40%–70% relative risk reduction. Accumulating data also suggests potential benefits from pharmacotherapy.