Impact of metabolic syndrome compared with impaired fasting glucose on the development of type 2 diabetes in a general Japanese population: the Hisayama study.
Impact of metabolic syndrome compared with impaired fasting glucose on the development of type 2 diabetes in a general Japanese population: the Hisayama study.
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DOI：
10.2337/dc09-0896
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发表时间：
2009-12
期刊：
影响因子：
16.2
通讯作者：
Kiyohara Y
中科院分区：
文献类型：
--
作者：
Mukai N;Doi Y;Ninomiya T;Hata J;Yonemoto K;Iwase M;Iida M;Kiyohara Y
我们研究了在日本普通人群中，代谢综合征是否比空腹血糖受损（IFG）更有效地预测2型糖尿病的发生。共有1，935名年龄在40-79岁之间的非糖尿病受试者接受了平均11.8年的前瞻性随访。在随访期间，286名受试者发生了2型糖尿病。与无代谢综合征的受试者相比，即使在校正了混杂因素、年龄、糖尿病家族史、总胆固醇、酒精摄入、吸烟习惯和规律锻炼后，患有代谢综合征的男性和女性受试者发生2型糖尿病的多变量校正风险比（HR）也显著较高（男性：HR 2.58 [95% CI 1.85-3.59];女性：3.69 [2.58-5.27]）。与IFG相比，2型糖尿病代谢综合征的多变量校正HR在男性中略低，在女性中相似。在有或无IFG的受试者中，随着代谢综合征组分数量的增加，2型糖尿病的多变量校正HR逐渐升高。在分层分析中，与既无代谢综合征也无IFG的受试者相比，单纯代谢综合征受试者（2.37 [1.45-3.88]）或单纯IFG受试者（3.49 [2.57-4.74]）的2型糖尿病多变量校正风险显著更高，同时患有代谢综合征和IFG的受试者（6.76 [4.75-9.61]）的风险显著更高。此外，多变量校正后的2型糖尿病风险在代谢综合征和IFG患者中也显著高于单独代谢综合征或IFG患者（均P < 0.001）。我们的研究结果表明，代谢综合征显着增加2型糖尿病的发病风险，独立于IFG，因此是一个有价值的工具，以确定个人在2型糖尿病的高风险。
We examined whether metabolic syndrome predicts incident type 2 diabetes more effectively than impaired fasting glucose (IFG) in a general Japanese population. A total of 1,935 nondiabetic subjects aged 40–79 years were followed-up prospectively for a mean of 11.8 years. During the follow-up, 286 subjects developed type 2 diabetes. Compared with those without metabolic syndrome, the multivariate-adjusted hazard ratio (HR) for incident type 2 diabetes was significantly higher in subjects of both sexes with metabolic syndrome, even after adjustment for confounding factors, age, family history of diabetes, total cholesterol, alcohol intake, smoking habits, and regular exercise (men: HR 2.58 [95% CI 1.85–3.59]; women: 3.69 [2.58–5.27]). The multivariate-adjusted HR of metabolic syndrome for type 2 diabetes was slightly lower in men and similar in women compared with that of IFG. The multivariate-adjusted HR for type 2 diabetes rose progressively as the number of metabolic syndrome components increased in both subjects with and without IFG. In stratified analysis, the multivariate-adjusted risk of type 2 diabetes was significantly higher in subjects with metabolic syndrome alone (2.37 [1.45–3.88]) or IFG alone (3.49 [2.57–4.74]) and markedly increased in subjects with both metabolic syndrome and IFG (6.76 [4.75–9.61]) than in subjects with neither metabolic syndrome nor IFG. Furthermore, the multivariate-adjusted risk for type 2 diabetes was also significantly higher in subjects with both metabolic syndrome and IFG than in those with either one alone (both P < 0.001). Our findings suggest that metabolic syndrome significantly increases the risk of incident type 2 diabetes, independent of IFG, and is therefore a valuable tool to identify individuals at high risk of type 2 diabetes.