Different Contributions of Dyslipidemia and Obesity to the Natural History of Type 2 Diabetes: 3-Year Cohort Study in China
Aim. It is known that different stages of type 2 diabetes represent distinct pathophysiological changes, but how the spectrum of risk factors varies at different stages is not yet clarified. Hence, the aim of this study was to compare the effect of different metabolic variables on the natural histor...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2019/4328975 |
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| author | Lu Liu Xiaoling Guan Zhongshang Yuan Meng Zhao Qiu Li Xu Zhang Haiqing Zhang Dongmei Zheng Jin Xu Ling Gao Qingbo Guan Jiajun Zhao the REACTION Study Group |
| author_facet | Lu Liu Xiaoling Guan Zhongshang Yuan Meng Zhao Qiu Li Xu Zhang Haiqing Zhang Dongmei Zheng Jin Xu Ling Gao Qingbo Guan Jiajun Zhao the REACTION Study Group |
| author_sort | Lu Liu |
| collection | DOAJ |
| description | Aim. It is known that different stages of type 2 diabetes represent distinct pathophysiological changes, but how the spectrum of risk factors varies at different stages is not yet clarified. Hence, the aim of this study was to compare the effect of different metabolic variables on the natural history of type 2 diabetes. Methods. A total of 5,213 nondiabetic (normal glucose tolerance (NGT) and prediabetes) Chinese older than 40 years participated this prospective cohort study, and 4,577 completed the 3-year follow-up. Glycemic status was determined by standard oral glucose tolerance test both at enrollment and follow-up visit. Predictors for conversion in glycemic status were studied in a corresponding subcohort using the multiple logistic regression analysis. Results. The incidence of prediabetes and diabetes of the cohort was 93.6 and 42.2 per 1,000 person-years, respectively. After a 3-year follow-up, 33.1% of prediabetes patients regressed to NGT. The predictive weight of body mass index (BMI), serum triglyceride, total cholesterol, and systolic blood pressure in different paths of conversions among diabetes, prediabetes, and NGT differed. Specifically, BMI was the strongest predictor for regression from prediabetes to NGT, while triglyceride was most prominent for onset of diabetes. One SD increase in serum triglyceride was associated with a 1.29- (95% CI 1.10–1.52; P=0.002) or 1.12- (95% CI 1.01–1.27; P=0.039) fold higher risk of diabetes for individuals with NGT or prediabetes, respectively. Conclusion. Risk factors for different stages of diabetes differed, suggesting personalized preventive strategies for individuals with different basal glycemic statuses. |
| format | Article |
| id | doaj-art-e8a894d015cb433bbe5731554178aa16 |
| institution | OA Journals |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-e8a894d015cb433bbe5731554178aa162025-08-20T02:22:01ZengWileyJournal of Diabetes Research2314-67452314-67532019-01-01201910.1155/2019/43289754328975Different Contributions of Dyslipidemia and Obesity to the Natural History of Type 2 Diabetes: 3-Year Cohort Study in ChinaLu Liu0Xiaoling Guan1Zhongshang Yuan2Meng Zhao3Qiu Li4Xu Zhang5Haiqing Zhang6Dongmei Zheng7Jin Xu8Ling Gao9Qingbo Guan10Jiajun Zhao11the REACTION Study Group12Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, ChinaDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, ChinaDepartment of Epidemiology and Biostatistics, School of Public Health, Shandong University, 250012, ChinaDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, ChinaDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, ChinaDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, ChinaDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, ChinaDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, ChinaDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, ChinaShandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, 250021, ChinaDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, ChinaDepartment of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, 250021, ChinaShanghai Jiao Tong University School of Medicine, ChinaAim. It is known that different stages of type 2 diabetes represent distinct pathophysiological changes, but how the spectrum of risk factors varies at different stages is not yet clarified. Hence, the aim of this study was to compare the effect of different metabolic variables on the natural history of type 2 diabetes. Methods. A total of 5,213 nondiabetic (normal glucose tolerance (NGT) and prediabetes) Chinese older than 40 years participated this prospective cohort study, and 4,577 completed the 3-year follow-up. Glycemic status was determined by standard oral glucose tolerance test both at enrollment and follow-up visit. Predictors for conversion in glycemic status were studied in a corresponding subcohort using the multiple logistic regression analysis. Results. The incidence of prediabetes and diabetes of the cohort was 93.6 and 42.2 per 1,000 person-years, respectively. After a 3-year follow-up, 33.1% of prediabetes patients regressed to NGT. The predictive weight of body mass index (BMI), serum triglyceride, total cholesterol, and systolic blood pressure in different paths of conversions among diabetes, prediabetes, and NGT differed. Specifically, BMI was the strongest predictor for regression from prediabetes to NGT, while triglyceride was most prominent for onset of diabetes. One SD increase in serum triglyceride was associated with a 1.29- (95% CI 1.10–1.52; P=0.002) or 1.12- (95% CI 1.01–1.27; P=0.039) fold higher risk of diabetes for individuals with NGT or prediabetes, respectively. Conclusion. Risk factors for different stages of diabetes differed, suggesting personalized preventive strategies for individuals with different basal glycemic statuses.http://dx.doi.org/10.1155/2019/4328975 |
| spellingShingle | Lu Liu Xiaoling Guan Zhongshang Yuan Meng Zhao Qiu Li Xu Zhang Haiqing Zhang Dongmei Zheng Jin Xu Ling Gao Qingbo Guan Jiajun Zhao the REACTION Study Group Different Contributions of Dyslipidemia and Obesity to the Natural History of Type 2 Diabetes: 3-Year Cohort Study in China Journal of Diabetes Research |
| title | Different Contributions of Dyslipidemia and Obesity to the Natural History of Type 2 Diabetes: 3-Year Cohort Study in China |
| title_full | Different Contributions of Dyslipidemia and Obesity to the Natural History of Type 2 Diabetes: 3-Year Cohort Study in China |
| title_fullStr | Different Contributions of Dyslipidemia and Obesity to the Natural History of Type 2 Diabetes: 3-Year Cohort Study in China |
| title_full_unstemmed | Different Contributions of Dyslipidemia and Obesity to the Natural History of Type 2 Diabetes: 3-Year Cohort Study in China |
| title_short | Different Contributions of Dyslipidemia and Obesity to the Natural History of Type 2 Diabetes: 3-Year Cohort Study in China |
| title_sort | different contributions of dyslipidemia and obesity to the natural history of type 2 diabetes 3 year cohort study in china |
| url | http://dx.doi.org/10.1155/2019/4328975 |
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