Predictive Value of Fasting Glucose, Postload Glucose, and Hemoglobin A1c on Risk of Diabetes and Complications in Chinese Adults

被引：172

作者：

Lu, Jieli ^{[1
]}

He, Jiang ^{[2
]}

Li, Mian ^{[1
]}

Tang, Xulei ^{[3
]}

Hu, Ruying ^{[4
]}

Shi, Lixin ^{[5
]}

Su, Qing ^{[6
]}

Peng, Kui ^{[1
]}

Xu, Min ^{[1
]}

Xu, Yu ^{[1
]}

Chen, Yuhong ^{[1
]}

Yu, Xuefeng ^{[7
]}

Yan, Li ^{[8
]}

Wang, Tiange ^{[1
]}

Zhao, Zhiyun ^{[1
]}

Qin, Guijun ^{[9
]}

Wan, Qin ^{[10
]}

Chen, Gang ^{[11
]}

Dai, Meng ^{[1
]}

Zhang, Di ^{[1
]}

Gao, Zhengnan ^{[12
]}

Wang, Guixia ^{[13
]}

Shen, Feixia ^{[14
]}

Luo, Zuojie ^{[15
]}

Qin, Yingfen ^{[15
]}

Chen, Li ^{[16
]}

Huo, Yanan ^{[17
]}

Li, Qiang ^{[18
]}

Ye, Zhen ^{[4
]}

Zhang, Yinfei ^{[19
]}

Du, Rui ^{[1
]}

Cheng, Di ^{[1
]}

Liu, Chao ^{[20
]}

Wang, Youmin ^{[21
]}

Wu, Shengli ^{[22
]}

Yang, Tao ^{[23
]}

Deng, Huacong ^{[24
]}

Li, Donghui ^{[25
]}

Lai, Shenghan ^{[26
]}

Bloomgarden, Zachary T. ^{[27
]}

Chen, Lulu ^{[28
]}

Zhao, Jiajun ^{[29
]}

Mu, Yiming ^{[30
]}

Ning, Guang ^{[1
]}

Wang, Weiqing ^{[1
]}

Bi, Yufang ^{[1
]}

机构：

[1] Shanghai Jiao Tong Univ, Shanghai Natl Clin Res Ctr Endocrine & Metab Dis, Shanghai Inst Endocrine & Metab Dis,Sch Med, Key Lab Endocrine Tumors,Minist Shanghai,Ruijin H, Shanghai, Peoples R China

[2] Tulane Univ, Dept Epidemiol, Sch Publ Hlth & Trop Med, New Orleans, LA 70118 USA

[3] Lanzhou Univ, Hosp 1, Lanzhou, Gansu, Peoples R China

[4] Zhejiang Prov Ctr Dis Control & Prevent, Hangzhou, Zhejiang, Peoples R China

[5] Guiyang Med Coll, Affiliated Hosp, Guiyang, Guizhou, Peoples R China

[6] Shanghai Jiao Tong Univ, Xinhua Hosp, Shanghai, Peoples R China

[7] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Wuhan, Hubei, Peoples R China

[8] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangzhou, Guangdong, Peoples R China

[9] Zhengzhou Univ, Affiliated Hosp 1, Zhengzhou, Henan, Peoples R China

[10] Southwest Med Univ, Affiliated Hosp, Luzhou, Peoples R China

[11] Fujian Med Univ, Fujian Prov Hosp, Fuzhou, Fujian, Peoples R China

[12] Dalian Municipal Cent Hosp, Dalian, Peoples R China

[13] Jilin Univ, Hosp 1, Changchun, Jilin, Peoples R China

[14] Wenzhou Med Univ, Affiliated Hosp 1, Wenzhou, Peoples R China

[15] Guangxi Med Univ, Affiliated Hosp 1, Nanning, Peoples R China

[16] Shandong Univ, Qilu Hosp, Jinan, Shandong, Peoples R China

[17] Nanchang Univ, Jiangxi Prov Peoples Hosp, Nanchang, Jiangxi, Peoples R China

[18] Harbin Med Univ, Affiliated Hosp 2, Harbin, Heilongjiang, Peoples R China

[19] Cent Hosp Shanghai Jiading Dist, Shanghai, Peoples R China

[20] Jiangsu Prov Hosp Integrat Chinese & Western Med, Nanjing, Jiangsu, Peoples R China

[21] Anhui Med Univ, Affiliated Hosp 1, Hefei, Anhui, Peoples R China

[22] Karamay Municipal Peoples Hosp, Karamay, Xinjiang, Peoples R China

[23] Nanjing Med Univ, Affiliated Hosp 1, Nanjing, Jiangsu, Peoples R China

[24] Chongqing Med Univ, Affiliated Hosp 1, Chongqing, Peoples R China

[25] Univ Texas MD Anderson Canc Ctr, Dept Gastrointestinal Med Oncol, Houston, TX 77030 USA

[26] Johns Hopkins Univ, Sch Med, Baltimore, MD USA

[27] Icahn Sch Med Mt Sinai, New York, NY 10029 USA

[28] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Wuhan, Hubei, Peoples R China

[29] Shandong Univ, Shandong Prov Hosp, Jinan, Shandong, Peoples R China

[30] Chinese Peoples Liberat Army Gen Hosp, Beijing, Peoples R China

来源：

DIABETES CARE | 2019年 / 42卷 / 08期

基金：

中国国家自然科学基金;

关键词：

CARDIOVASCULAR-DISEASE; NONDIABETIC HYPERGLYCEMIA; GLYCATED HEMOGLOBIN; REGRESSION-MODELS; MORTALITY; COHORT; A1C; PREVALENCE; GLYCEMIA; MEN;

D O I：

10.2337/dc18-1390

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

OBJECTIVE Uncertainty remains regarding the predictive value of various glycemic measures as they relate to the risk of diabetes and its complications. Using the cutoffs recommended by the American Diabetes Association's 2010 criteria, we determined the associations of fasting plasma glucose (FPG), 2-h postload glucose (2h-PG), and HbA(1c) with the outcomes. RESEARCH DESIGN AND METHODS Baseline medical history, FPG, 2h-PG, and HbA(1c) were obtained from a population-based cohort of 193,846 adults aged >= 40 years in China during 2011-2012. A follow-up visit was conducted during 2014-2016 in order to assess incident diabetes, cardiovascular disease (CVD), cancer, and mortality. RESULTS We documented 8,063 cases of diabetes, 3,014 CVD-related events, 1,624 cases of cancer, and 2,409 deaths during up to 5 years of follow-up. Multivariable-adjusted risk ratios (95% CIs) of diabetes associated with prediabetes based on FPG of 100-125 mg/dL, 2h-PG of 140-199 mg/dL, or HbA(1c) of 5.7-6.4% (39-47 mmol/mol) were 1.60 (1.43-1.79), 2.72 (2.43-3.04), and 1.49 (1.36-1.62), respectively. Restricted cubic spline analyses suggested J-shaped associations of FPG, 2h-PG, and HbA(1c) levels with CVD, cancer, and mortality. Multivariable-adjusted hazard ratios (95% CIs) associated with untreated diabetes based on FPG >= 126 mg/dL, 2h-PG >= 200 mg/dL, or HbA(1c) >= 6.5% (48 mmol/mol) were 1.18 (1.05-1.33), 1.31 (1.18-1.45), and 1.20 (1.07-1.34) for CVD; 1.10 (0.92-1.32), 1.44 (1.25-1.67), and 1.08 (0.92-1.28) for cancer; and 1.37 (1.20-1.57), 1.57 (1.41-1.76), and 1.33 (1.17-1.52) for mortality, respectively. 2h-PG remained significantly associated with outcomes in models including FPG and HbA(1c) as spline terms. Furthermore, 2h-PG significantly improved the ability of the C statistic to predict diabetes, CVD, and mortality. CONCLUSIONS 2h-PG remains independently predictive of outcomes in models including FPG and HbA(1c). Therefore, in addition to FPG and HbA(1c), routine testing of 2h-PG should be considered in order to better assess the risks of outcomes.

引用

页码：1539 / 1548

页数：10

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