Prevalence of prediabetes and risk factors in the general adult population of Croatia - EH-UH 2 study

: Introduction: Prediabetes is a state of elevated blood glucose, but not high enough to be classified as diabetes. The prevalence depends on the criteria used in the definition of prediabetes and on the observed populations. Known risk factors are obesity, age ≥ 45 years, positive family history of type 2 diabetes, insufficient physical activity, arterial hypertension, dyslipidaemia, and positive smoking status. The aim of our study was to determine the prevalence of prediabetes in a randomized, representative sample of the adult population of the Republic of Croatia and to determine the association and predictability of risk factors. Materials and methods: Out of 1219 adult participants who were involved in the scientific research project EHUH-2, 687 met the final criteria. All participants underwent clinical examination. Personal and family history were obtained from the collected data in the questionnaire. The participants were instructed to fast for 12 hours before the blood draw and were given detailed instructions on collecting a 24-hour urine sample. According to the ADA criteria, prediabetes is defined as a fasting glucose value between 5.6, and 6.9 mmol/L. Results: The prevalence of prediabetes in our sample was 11.1%. Predictive factors for prediabetes were older age, male gender, higher body weight, higher body mass index, larger waist circumference, higher systolic and diastolic blood pressure, larger body surface area, a higher percentage of visceral fat, decreased glomerular filtration rate, higher serum uric acid levels, and greater albuminuria (ACR). The final hierarchical regression model, which included body mass index, systolic and diastolic blood pressure, waist circumference, age, gender, eGFR, information on smoking, albuminuria, and urate, was statistically significant (p < ; 0.001; Nagelkerke R2=0,272). Conclusion: Our study is the first in which the prevalence of prediabetes and its association with risk factors were determined in a representative randomized sample of the general adult population of Croatia. While further research is needed, our results shows that in the presence of multiple risk factors for prediabetes, the focus should be on age, systolic blood pressure, and albuminuria as the main predictive factors of prediabetes, especially in individuals with visceral obesity.