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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Main Authors: 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
Format: Article
Language:English
Published: Wiley 2019-01-01
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.
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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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