Secular changes in U.S. Prediabetes prevalence defined by hemoglobin A1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999-2010.
Secular changes in U.S. Prediabetes prevalence defined by hemoglobin A1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999-2010.
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血红蛋白A1C和禁食等离子体葡萄糖定义的美国前糖尿病前期的世俗变化：国家健康和营养检查调查，1999-2010。
DOI：
10.2337/dc12-2563
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发表时间：
2013-08
期刊：
影响因子：
16.2
通讯作者：
Caspersen CJ
中科院分区：
文献类型：
--
作者：
Bullard KM;Saydah SH;Imperatore G;Cowie CC;Gregg EW;Geiss LS;Cheng YJ;Rolka DB;Williams DE;Caspersen CJ
使用具有全国代表性的美国平民非制度化人口样本，我们估计了1999-2010年期间糖尿病前期的患病率及其变化。数据来自19，182名年龄≥12岁的非妊娠个体，他们参加了1999-2010年国家健康和营养检查调查。我们将糖尿病前期定义为血红蛋白A1 c（A1 C）5.7至<6.5%（39至<48 mmol/mol，A1C5.7）或空腹血糖（FPG）100至<126 mg/dL（空腹血糖受损[IFG]）。我们估计了1999-2002年、2003-2006年和2007-2010年糖尿病前期、A1C5.7和IFG的患病率。我们计算了根据2000年美国人口普查人口年龄标准化的估计值，并使用逻辑回归计算了年龄，性别，种族/民族，贫困收入比和BMI的估计值。纳入了自我报告患有糖尿病、A1 C ≥6.5%（≥48 mmol/mol）或FPG ≥126 mg/dL的受试者。在年龄≥12岁的人群中，经年龄调整的糖尿病前期患病率从1999-2002年的27.4%（95%CI 25.1-29.7）增加到2007-2010年的34.1%（32.5-35.8）。在≥18岁的成人中，患病率从29.2%（26.8-31.8）增加到36.2%（34.5-38.0）。作为年龄≥12岁个体的单一指标，A1C5.7患病率从9.5%（8.4-10.8）增加到17.8%（16.6-19.0），相对增加了87%，而IFG保持稳定。在控制协变量后，这些患病率变化在总人群中、各亚组中相似。在1999-2010年期间，由于A1C5.7的增加，美国前驱糖尿病患病率增加。需要对前驱糖尿病进行持续监测，以识别、量化和描述正在进行的糖尿病一级预防工作的高危人群。
Using a nationally representative sample of the civilian noninstitutionalized U.S. population, we estimated prediabetes prevalence and its changes during 1999–2010. Data were from 19,182 nonpregnant individuals aged ≥12 years who participated in the 1999–2010 National Health and Nutrition Examination Surveys. We defined prediabetes as hemoglobin A1c (A1C) 5.7 to <6.5% (39 to <48 mmol/mol, A1C5.7) or fasting plasma glucose (FPG) 100 to <126 mg/dL (impaired fasting glucose [IFG]). We estimated the prevalence of prediabetes, A1C5.7, and IFG for 1999–2002, 2003–2006, and 2007–2010. We calculated estimates age-standardized to the 2000 U.S. census population and used logistic regression to compute estimates adjusted for age, sex, race/ethnicity, poverty-to-income ratio, and BMI. Participants with self-reported diabetes, A1C ≥6.5% (≥48 mmol/mol), or FPG ≥126 mg/dL were included. Among those aged ≥12 years, age-adjusted prediabetes prevalence increased from 27.4% (95% CI 25.1–29.7) in 1999–2002 to 34.1% (32.5–35.8) in 2007–2010. Among adults aged ≥18 years, the prevalence increased from 29.2% (26.8–31.8) to 36.2% (34.5–38.0). As single measures among individuals aged ≥12 years, A1C5.7 prevalence increased from 9.5% (8.4–10.8) to 17.8% (16.6–19.0), a relative increase of 87%, whereas IFG remained stable. These prevalence changes were similar among the total population, across subgroups, and after controlling for covariates. During 1999–2010, U.S. prediabetes prevalence increased because of increases in A1C5.7. Continuous monitoring of prediabetes is needed to identify, quantify, and characterize the population of high-risk individuals targeted for ongoing diabetes primary prevention efforts.