Factors correlated with targeted prevention for prediabetes classified by impaired fasting glucose, impaired glucose tolerance, and elevated HbA1c: A population-based longitudinal study

Xiaoyue Zhu; Zhipeng Yang; Zhiliang He; Jingyao Hu; Tianxiu Yin; Hexiang Bai; Ruoyu Li; Le Cai; Haijian Guo; Mingma Li; Tao Yan; You Li; Chenye Shen; Kaicheng Sun; Yu Liu; Zilin Sun; Bei Wang

doi:10.3389/fendo.2022.965890

Factors correlated with targeted prevention for prediabetes classified by impaired fasting glucose, impaired glucose tolerance, and elevated HbA1c: A population-based longitudinal study

Front Endocrinol (Lausanne). 2022 Aug 22:13:965890. doi: 10.3389/fendo.2022.965890. eCollection 2022.

Authors

Xiaoyue Zhu¹, Zhipeng Yang², Zhiliang He¹, Jingyao Hu¹, Tianxiu Yin¹, Hexiang Bai¹, Ruoyu Li¹, Le Cai¹, Haijian Guo³, Mingma Li¹, Tao Yan¹, You Li¹, Chenye Shen¹, Kaicheng Sun⁴, Yu Liu⁵, Zilin Sun⁶, Bei Wang¹

Affiliations

¹ Key Laboratory of Environment Medicine and Engineering of Ministry of Education, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.
² School of Software, Fudan University, Shanghai, China.
³ Integrated Business Management Office, Jiangsu Province Centre Disease Control and Prevention, Nanjing, China.
⁴ Yandu Centre for Disease Control and Prevention, Yancheng, China.
⁵ Jurong Centre for Disease Control and Prevention, Jurong, China.
⁶ Department of Endocrinology, Institute of Diabetes, Medical School, Southeast University, Nanjing, China.

Abstract

Background: There is still controversy surrounding the precise characterization of prediabetic population. We aim to identify and examine factors of demographic, behavioral, clinical, and biochemical characteristics, and obesity indicators (anthropometric characteristics and anthropometric prediction equation) for prediabetes according to different definition criteria of the American Diabetes Association (ADA) in the Chinese population.

Methods: A longitudinal study consisted of baseline survey and two follow-ups was conducted, and a pooled data were analyzed. Prediabetes was defined as either impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or elevated glycosylated hemoglobin (HbA1c) according to the ADA criteria. Robust generalized estimating equation models were used.

Results: A total of 5,713 (58.42%) observations were prediabetes (IGT, 38.07%; IGT, 26.51%; elevated HbA1c, 23.45%); 9.66% prediabetes fulfilled all the three ADA criteria. Among demographic characteristics, higher age was more evident in elevated HbA1c [adjusted OR (aOR)=2.85]. Female individuals were less likely to have IFG (aOR=0.70) and more likely to suffer from IGT than male individuals (aOR=1.41). Several inconsistency correlations of biochemical characteristics and obesity indicators were detected by prediabetes criteria. Body adiposity estimator exhibited strong association with prediabetes (D10: aOR=4.05). For IFG and elevated HbA1c, the odds of predicted lean body mass exceed other indicators (D10: aOR=3.34; aOR=3.64). For IGT, predicted percent fat presented the highest odds (D10: aOR=6.58).

Conclusion: Some correlated factors of prediabetes under different criteria differed, and obesity indicators were easily measured for target identification. Our findings could be used for targeted intervention to optimize preventions to mitigate the obviously increased prevalence of diabetes.

Keywords: correlated factors; epidemiology; obesity indicators; prediabetes; prevention.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Blood Glucose
Diabetes Mellitus* / epidemiology
Diabetes Mellitus* / prevention & control
Fasting
Female
Glucose Intolerance* / epidemiology
Glycated Hemoglobin / analysis
Humans
Longitudinal Studies
Male
Obesity / epidemiology
Prediabetic State* / epidemiology

Substances

Blood Glucose
Glycated Hemoglobin A