| To investigate the characteristics of pre-diabetes population conversion, we selected moderate-elderly population of Shijingshan community in Beijing and made a 4-year follow-up. The population were divided into normal glucose metabolism (NGT) and impaired glucose regulation (IGR).We recorded the baseline clinical characteristics, analyzed the natural conversion of different glucose metabolism status and the related factors to conversion. analyzed the prevalence and natural conversion of microalbuminuria, investigated the effect of microalbuminuria for predicting cardiovascular disease mortality and total mortality risk,The results showed that IFG threshold from the 6.1mmol/L down to 5.6mmol/L, IFG and IFG/IGT constituent ratio increased 5 times and 2.8 times. The prevelance of complicated with cardiovascular disease, hypertension, dyslipidemia, and microalbuminuria were significantly higher in IFG1 than NGT group. The annual conversion rate to DM was IFG/IGT (5.2%)＞IFG2 (5.0%)> IGT (2.9%)＞IFG1 (2.7%)> NGT (1.2%). Logistic regression analysis showed that the risk factors of NGT transferred to IGR or DM were FPG (OR= 3.96,95% CI 1.97～7.96, P=0.001) and 2hPG (OR=1.37,95% CI 1.13～1.66, P=0.002). The risk factors of IGR transferred to DM were FPG (OR= 4.09,95% CI 2.32～7.20, P=0.000),2hPG (OR=1.42,95% CI 1.21～1.68, P= 0.000), BMI (OR=1.16,95% CI 1.08～1.34, P＜0.05), HBCI/IR negatively correlated (OR=1.027,95% CI 0.862～1.316, P=0.001).The prevalence of MAU in non-diabetic population was 7.3%, and increased with age. The prevalence of MAU in IFG/IGT was 13.3%, followed by the IGT group (10.8%). The SBP, DBP, FPG,2hPQ TG, LDL-C, UA, CREA,2hINS and HOMA-IR were significantly higher when compared with the baseline state in UAER progressed population, and HBCI/IR,△I120/△G120/IR were significantly decreased. Multiple logistic regression analysis showed that SBP, 2hPQ TG,2hINS and HOMA-IR were independent risk factors for the progress of UAER.The all-cause mortality was 8.7/1000 person-year in total population. CVD and malignant tumor were the main causes of death. Compared with the survival population, and the proportion of combined with MIAU, MAAU, and DM significantly were significantly higher in death population. The all-cause mortality were 6.8‰,20.6‰,58.8‰in NAU, MIAU, MAAU population respectively. In the NAU population, malignant tumor was the leading cause of death, followed by cardiovascular disease. While in MIAU and MAAU population, cardiovascular disease was the primary cause of death. After age, blood glucose, hypertension, dyslipidemia and other factors were adjusted, compared with the NAU, the risk of death of cardiovascular disease was increased by 1.72 times and of all-cause death increased by 1.01 times in MIAU group, risk of death of cardiovascular disease increased by 3.87 times and of all-cause death increased by 2.76 times in MAAU group. NAU as the control group, adjusted for age, blood glucose, blood pressure, lipid disorders by Cox regression,18.32% of CVD deaths and 11.96% of all deaths could be attributed to the ACR≥30mg/g.So the conclusions of our study were as followed:1.The cutpoint reduction of IFG had a significant influence to the constituent ratio of NGT and IGR groups. The prevelance complicated with cardiovascular disease, hypertension, dyslipidemia, or microalbuminuria significantly was higher in IFG1 than NGT group.2. Plasma glucose, especially fasting glucose, could predict the deterioration of glucose metabolism in NGT and IGR population. Obese played an important role for the conversion to DM, especially in the IGT group. And the hyperinsulinemia and insulin resistance influenced the NGT-IGR transfer process. The decreasedβ-cell function influenced the IGR-DM transfer process. 3. The MAU level in non-diabetic population was more closely related with postprandial plasma glucose. And MAU was related closely with hypertension, high plasma glucose, dyslipidemia and insulin resistance.4. Cardiovascular disease and malignant tumor were the main mortality causes for the total population. In the NAU population, malignant tumor was the leading cause of death, followed by cardiovascular disease. In MIAU and MAAU population, cardiovascular disease was the primary cause of death. Compared with NAU group, CVD deaths and all-cause deaths were significantly increased in MIAU and MAAU population.
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