Linking extent of return to fasting state after oral glucose tolerance test to future risk of prediabetes and type 2 diabetes: Insights from the TLGS

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation Pub Date : 2024-09-29 DOI:10.1111/jdi.14308

Soroush Masrouri, Seyed Saeed Tamehri Zadeh, Maryam Tohidi, Fereidoun Azizi, Farzad Hadaegh

{"title":"Linking extent of return to fasting state after oral glucose tolerance test to future risk of prediabetes and type 2 diabetes: Insights from the TLGS","authors":"Soroush Masrouri, Seyed Saeed Tamehri Zadeh, Maryam Tohidi, Fereidoun Azizi, Farzad Hadaegh","doi":"10.1111/jdi.14308","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>To assess the risk of difference between 2 h post-load plasma glucose (2 h-PG) and fasting plasma glucose (FPG) on incident prediabetes/type 2 diabetes (T2DM) among normoglycemic individuals.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Among 4,971 individuals aged ≥20 years, the associations of the difference between 2 h-PG and FPG with outcomes were examined using multivariable-adjusted Cox regression analysis. Participants were categorized into three groups: a low post-load group (2 h-PG ≤ FPG, as the reference group); a high post-load group (2 h-PG > FPG and ≥75th percentile of the difference); and a medium post-load group (2 h-PG > FPG and <75th percentile of the difference), which was further categorized into three groups by equal ranges.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Over a median of 11.5 years of follow-up, 2,331 new cases of prediabetes/type 2 diabetes and 360 cases of type 2 diabetes occurred. Greater risks of incident prediabetes/type 2 diabetes in second (9–16 mg/dL) and third (17–24 mg/dL) medium post-load, as well as high post-load (≥25 mg/dL) categories, were found, with hazard ratios (95% confidence intervals) of 1.26 (1.11–1.44), 1.32 (1.15–1.51), and 1.69 (1.51–1.90), respectively; the issue was more prominent among women (<i>P</i> for interaction = 0.005). The risk of incident type 2 diabetes was also higher for these categories. After further adjustment for the homeostasis model assessment of insulin resistance, result remained essentially unchanged. Even among individuals with low normal FPG (i.e., <90 mg/dL), ≥9 mg/dL difference between 2 h-PG and FPG increased the risk of composite prediabetes/ type 2 diabetes.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Greater levels of 2 h-PG as low as 9 mg/dL than FPG among normoglycemic individuals is a harbinger of prediabetes/type 2 diabetes development.</p>\n </section>\n </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"15 12","pages":"1743-1752"},"PeriodicalIF":3.1000,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14308","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Diabetes Investigation","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jdi.14308","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Aims

To assess the risk of difference between 2 h post-load plasma glucose (2 h-PG) and fasting plasma glucose (FPG) on incident prediabetes/type 2 diabetes (T2DM) among normoglycemic individuals.

Methods

Among 4,971 individuals aged ≥20 years, the associations of the difference between 2 h-PG and FPG with outcomes were examined using multivariable-adjusted Cox regression analysis. Participants were categorized into three groups: a low post-load group (2 h-PG ≤ FPG, as the reference group); a high post-load group (2 h-PG > FPG and ≥75th percentile of the difference); and a medium post-load group (2 h-PG > FPG and <75th percentile of the difference), which was further categorized into three groups by equal ranges.

Results

Over a median of 11.5 years of follow-up, 2,331 new cases of prediabetes/type 2 diabetes and 360 cases of type 2 diabetes occurred. Greater risks of incident prediabetes/type 2 diabetes in second (9–16 mg/dL) and third (17–24 mg/dL) medium post-load, as well as high post-load (≥25 mg/dL) categories, were found, with hazard ratios (95% confidence intervals) of 1.26 (1.11–1.44), 1.32 (1.15–1.51), and 1.69 (1.51–1.90), respectively; the issue was more prominent among women (P for interaction = 0.005). The risk of incident type 2 diabetes was also higher for these categories. After further adjustment for the homeostasis model assessment of insulin resistance, result remained essentially unchanged. Even among individuals with low normal FPG (i.e., <90 mg/dL), ≥9 mg/dL difference between 2 h-PG and FPG increased the risk of composite prediabetes/ type 2 diabetes.

Conclusions

Greater levels of 2 h-PG as low as 9 mg/dL than FPG among normoglycemic individuals is a harbinger of prediabetes/type 2 diabetes development.

Abstract Image

查看原文本刊更多论文

将口服葡萄糖耐量试验后恢复到空腹状态的程度与未来罹患糖尿病前期和 2 型糖尿病的风险联系起来：来自 TLGS 的启示。

目的：在血糖正常的人群中，评估负荷后 2 小时血浆葡萄糖（2 h-PG）与空腹血浆葡萄糖（FPG）之间的差异对糖尿病前期/2 型糖尿病（T2DM）发病的风险：在 4971 名年龄≥20 岁的人群中，采用多变量调整 Cox 回归分析法研究了 2 h-PG 和 FPG 之间的差异与结果的关系。参与者被分为三组：低负荷后组（2 h-PG ≤ FPG，作为参照组）；高负荷后组（2 h-PG > FPG 且差值≥第 75 百分位数）；中负荷后组（2 h-PG > FPG 且结果：在中位数为 11.5 年的随访期间，新增 2 331 例糖尿病前期/2 型糖尿病病例和 360 例 2 型糖尿病病例。结果发现，负荷后第二（9-16 毫克/分升）和第三（17-24 毫克/分升）中度负荷以及负荷后高度负荷（≥25 毫克/分升）类别发生糖尿病前期/2 型糖尿病的风险更大，危险比（95% 置信区间）分别为 1.26（1.11-1.44）、1.32（1.15-1.51）和 1.69（1.51-1.90）；这一问题在女性中更为突出（交互作用 P = 0.005）。这些类别的人群罹患 2 型糖尿病的风险也更高。进一步调整胰岛素抵抗平衡模型评估后，结果基本保持不变。即使在 FPG 正常值较低的个体中（即，结论：在血糖正常的人群中，2 h-PG 低至 9 mg/dL 的水平高于 FPG 是糖尿病前期/2 型糖尿病发展的先兆。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Diabetes Investigation ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

9.40%

发文量

218

审稿时长

6-12 weeks

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).