Prevalence And Incidence Rate And Influencing Factors Of Type 2 Diabetes Mellitus And Impaired Fasting Glucose Among A Population Held Physical Examination

ObjectiveTo understand the prevalence and incidence of type 2 diabetes mellitus(T2DM)and impaired fasting glucose(IFG)in a physical examination population in Tianjin,and to explore the factors affecting the prevalence and incidence of T2 DM and IFG,so as to provide a scientific basis for the prevention and treatment of T2 DM.MethodsThe study was divided into two parts.The first part was to analyze the prevalence of T2 DM and IFG in physical examination population in Tianjin in 2015 which including 15499 participants.The Logistic regression model was used to analyze the factors affecting the prevalence of T2 DM and IFG,the restricted cubic spline model was used to estimate the dose-response relationship between BMI and the risk of T2 DM and IFG.The second part was to analyze the incidence of T2 DM and IFG in a population which took physical examination in together.The Cox regression model was used to analyze the factors affecting the incidence of T2 DM and IFG,the restricted cubic spline model was used to estimate the dose-response relationship between BMI and the risk of T2 DM and IFG,the BMI changes and the risk of T2 DM and IFG.Result1.The prevalence of T2 DM was 8.8% in a physical examination population in 2015,which increased with age(P trend <0.001);The prevalence(11.7%)of T2 DM in males was significantly higher than that(5.8%)in females(P < 0.001).The prevalence of IFG was 10.3%,which increased with age(P trend<0.001);The prevalence(12.7%)of IFG in males was significantly higher than that(7.8%)in females(P < 0.001).2.The multiple factors Logistic regression analysis showed that the related factors of T2 DM and IFG were increased age,male,high TG,high TC,overweight,obesity,and hypertension.The restrictive cubic spline analysis indicated that the non-linear dose-response relationship was found between the BMI and the T2 DM and IFG in the general population.the dose-response relationship were found between the BMI and the T2 DM and IFG in both different genders and different age groups.3.The three-year cumulative incidence of T2 DM was 3.2%,the incidence density of T2 DM was 10.87/1000 person-years,The three-year cumulative incidence(5.0%)of T2 DM in males was significantly higher than that(1.2%)in females(P < 0.001);The three-year cumulative incidence(16.4%)of T2 DM in IFG group was significantly higher than that(1.8%)in normal blood glucose group(P < 0.001).The three-year cumulative incidence of IFG was 3.0%,the incidence density was 10.10/1000 personyears;The three-year cumulative incidence(4.2%)of IFG in males was significantly higher than that(1.7%)in females(P < 0.001).4.The Cox regression analysis found that after adjusting for age and gender,high TG,hypertension,decreased HDL-C,overweight,obesity and IFG at baseline increased the risk of T2DM;high TG,hypertension,decreased HDL-C,overweight,and obesity at baseline increased the risk of IFG.The change of BMI status was also the influencing factor of T2 DM and IFG.Compared with continuous normal/slim state,reversal from overweight/obesity to normal/slim state didn’t increase the risk of T2 DM and IFG while continued overweight/obesity increases the risk of T2 DM and IFG,HR(95% CI)were 6.890(3.324,14.280),2.347(1.462,3.767).Analysis of multivariate Cox regression showed that IFG,increased age,overweight,and obesity were risk factors for T2DM;increased TG,increased age,overweight,and obesity were risk factors for IFG.5.The restrictive cubic spline analysis indicated that the linear dose-response relationship was found between the BMI and the risk of the incidence of T2 DM and IFG in man and in women;the linear dose-response relationship was found between the change of BMI(the change of BMI =BMI2018-BMI2015)and the risk of the incidence of T2 DM and there was no relation in female;there was no significant dose-response relationship between the change of BMI and the risk of the incidence of IFG.Conclusion1.The prevalence of T2 DM and IFG is increasing with age in physical examination population,and the prevalence and incidence of T2 DM and IFG is higher in male than that in female.2.With the increase of BMI,the risk of T2 DM and IFG increased.With the increase of baseline BMI,the onset risk of T2 DM and IFG increased linearly.High BMI is an independent and dose-dependent risk factor for the onset of T2 DM and IFG.