Incidence of Type 2 diabetes in the elderly German population and the effect of clinical and lifestyle risk factors: KORA S4/F4 cohort study
Incidence of Type 2 diabetes in the elderly German population and the effect of clinical and lifestyle risk factors: KORA S4/F4 cohort study
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DOI：
10.1111/j.1464-5491.2009.02863.x
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发表时间：
2009-12-01
影响因子：
3.5
通讯作者：
Meisinger, C.
中科院分区：
文献类型：
--
作者：
Rathmann, W.;Strassburger, K.;Meisinger, C.
AimsTo确定2型糖尿病的发病率在老年人群中，在德国和其与临床和生活方式factors.MethodsOral葡萄糖耐量试验（OGTT，世界卫生组织标准）进行了随机抽样的1353例（年龄组55-74岁，62%的反应）在奥格斯堡（南部德国）（1999-2001年）。2006-2008年对该队列进行了重新调查。没有糖尿病的人（基线），887（74%）人参加了随访。（10.5%）在7年随访期内发生糖尿病（标准化发病率[95%置信区间（CI）]/1000人-年：总计15.5; 12.6，19.1;男性20.2; 15.6，26.1;女性11.3; 7.9、16.1}。在两种性别中，那些患糖尿病的人年龄稍大，更肥胖，有更不利的代谢特征（更高的葡萄糖值，HbA（1c），空腹胰岛素，尿酸和甘油三酯），并且在基线时比未患糖尿病的参与者更容易患高血压（P < 0.05）。在逐步Logistic回归分析中，年龄、父母糖尿病、体重指数、尿酸、当前吸烟、HbA（1c）和空腹和2小时血糖（OGTT）是糖尿病发病率的强预测因子。单纯性糖耐量受损的受试者患糖尿病的风险更高（比值比8.8; 95% CI 5.0，15.6）（4.7; 2.2，10.0），但差异未达到统计学意义。结论首次，我们估计了德国老年人群中2型糖尿病的发病率，并证明其在欧洲是最高的。OGTT似乎有助于识别2型糖尿病高风险个体。我们的研究结果支持吸烟在糖尿病进展中的作用。
AimsTo determine the incidence of Type 2 diabetes in an elderly population in Germany and its association with clinical and lifestyle factors.MethodsOral glucose tolerance tests (OGTT, World Health Organization criteria) were carried out in a random sample of 1353 subjects (age group 55-74 years; 62% response) in Augsburg (Southern Germany) (1999-2001). The cohort was re-investigated in 2006-2008. Of those individuals without diabetes (baseline), 887 (74%) participated in the follow-up.ResultsNinety-three (10.5%) developed diabetes during the 7-year follow-up period {standardized incidence rates [95% confidence interval (CI)] per 1000 person-years: total 15.5; 12.6, 19.1; men 20.2; 15.6, 26.1; women 11.3; 7.9, 16.1}. In both sexes, those who developed diabetes were slightly older, were more obese, had a more adverse metabolic profile (higher glucose values, HbA(1c), fasting insulin, uric acid, and triglycerides) and were more likely to have hypertension at baseline than were participants remaining free of diabetes (P < 0.05). On stepwise logistic regression, age, parental diabetes, body mass index, uric acid, current smoking, HbA(1c) and fasting and 2-h glucose (OGTT) were strong predictors of diabetes incidence. The risk of diabetes was higher in subjects with isolated impaired glucose tolerance (odds ratio 8.8; 95% CI 5.0, 15.6) than in isolated impaired fasting glucose (4.7; 2.2, 10.0), although the difference did not reach statistical significance.ConclusionsFor the first time, we have estimated the incidence of Type 2 diabetes in an elderly German cohort and demonstrated that it is among the highest in Europe. The OGTT appears to be useful in identifying individuals with high Type 2 diabetes risk. Our results support a role of smoking in the progression to diabetes.