| Objective:To analyze the relationship of microalbuminuria and the outcome of pre-diabetes populations and provide the epidemiological evidence on the prevention and control of diabetes, we conducted a prospective cohort study.Methods:The baseline data of 3075 participants aged 40 years old and above in urban fringe area of the city were selected, which were set up from the baseline survey from Risk Evaluation of cancers in Chinese Diabetic Individuals:a Longitudinal (REACTION) study (Luzhou Region) that was launched by Chinese Society of Endocrinology in April-November 2011 and were followed up in June 2014.The microalbuminuria(MAU) refered to the urinary albumin-to-creatinine ratio (ACR) reaches up to 2.5-25mg/mmol (male) or 3.5-35 mg/mmol (female), ruling out fever, congestive heart failure,or the acute and chronic kidney disease.Participants underwent 82.5g oral glucose-tolerance test(OGTT), and fasting and 2-hour glucose levels were measured to identify normal glucose tolerance and prediabetes (i.e., impaired fasting glucose or impaired glucose tolerance).The population was divided into groups according to the different ACR and different glucose metabolism. Background information was collected by a questionnaire survey(for instance, gender,age, height,weight,blood pressure,waistline,smoking and alcohol consumption, family history).The contents of the laboratory examination included fasting blood glucose,2-hours postprandial glucose, hemoglobin Ale, triglyceride(TG), High density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C)).The outcomes and influencing factors of the conversion from prediabetes to diabetes after three years follow-up were analyzed and clinical characteristics of different groups was investigated, then the related factors of MAU influenced on the conversion from pre-diabetes to diabetes in the population were analyzed by Logistic regression.Results:1.A total of 2482 cases in non-diabetes were selected for the study at baseline and 2042 cases were followed up, the follow-up rate was 82.3%, including 1238 NGT cases and 804 IGR cases were followed up and accounted for 60.6% and 39.4%.2.The population was divided into isolated NGT group, NGT+MAU group,isolated IGR group and IGR+MAU group according to the different ACR. The results showed that the age,FBQ2hPG,HbA1c,TG in NGT+MAU group,isolated IGR group and IGR+MAU group were significantly higher than those in isolated NGT group(P<0.05). The HDL-C in IGR+MAU group was significantly lower than that in isolated NGT group(P<0.05) and the age,HbAlc in IGR+MAU group were significantly higher than isolated IGR group (P<0.01).3.The ratio of complicated cardiovascular disease was 7.3%, dyslipidemia was 64.5%, which was significantly higher in IGR+MAU group than isolated NGT group (P<0.05).4.The accumulative total transformation rate to DM was IGR+MAU (33.6%)>IGR(22.8%)>NGT+MAU (10.9%)>NGT (5.6%). If the relative risk of isolated NGT to DM was set to 1, the risk of transferred to DM in NGT+MAU, isolated IGR, and IGR+MAU group were increased byl.05 times,3.93 times, and 7.50 times.5.The 2hPQ,TG,LDL-C were significantly higher in the four groups when compared with the baseline state(P< 0.05),while the HbAlc were significantly decreased(P<0.05).5. Logistic regression analysis showed that the risk factors of NGT, NGT+MAU, IGR, IGR+MAU transferred to DM were age,FBQ 2hPQ HbA1c,which were positive correlated.When the age, FBG,2hPG, HbAlc and other related factors were adjusted,MAU can make the relative risk of diabetes increased by 47.7%.Conclusions:1.The age,FBG,2-hPG,HbA1c and TG in IGR+MAU group were significantly higher than that of other groups, and both complicating dyslipide-mia and cardiovascular diseases were higher than isolated NGT group.2.The conversion rate to DM in IGR+MAU group was obviously higher than that of isolated IGR, NGT+MAU, and isolated NGT group, so the microalbuminuria may predict deterioration of glucose metabolism in NGT and IGR population. 3.The conversion rate to DM in IGR+MAU group was obviously higher than that of the same research object of IFG and IGT-DM. accordingly, we should pay special attention to screen MAU in individuals without diabetes, especially for IGR population.Objective:To analyze the relationship of hemoglobin Alc (HbAlc) levels and the outcome of pre-diabetes populations, we conducted a prospective cohort study.The aim of this survey was to provide the epidemiological evidence in order to prevent and control the diabetes.Methods:The baseline data of 3075 participants aged 40 years old and above in urban fringe area of the city were selected, which were set up from the baseline survey from Risk Evaluation of cancers in Chinese Diabetic Individualsia Longitudinal (REACTION) study (Luzhou Region) that was launched by Chinese Society of Endocrinology in April-November 2011 and were followed up in June 2014.All the subjects investigated received 75 g oral glucose tolerance test (OGTT) for diabetes screening carried out in November 2011 and June 2014,and fasting and 2-hour glucose levels were measured to identify normal glucose tolerance and prediabetes (i.e., impaired fasting glucose or impaired glucose tolerance).The participants were divided into groups according to the different HbAlc levels.Background information was collected by a questionnaire survey (for instance, gender,age,height, weight,blood, pressure,waistline, smoking and alcohol consumption,family history). The contents of the laboratory examination included fasting blood glucose,2-hours postprandial glucose, hemoglobin Alc,triglyceride(TG),High density lipopro-tein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C).The conversion of 3 years follow-up of different groups were investigated, then the related factors of HbA1c levels influenced on the conversion in pre-diabetes population were analyzed by Logistic regression.Results:1.The population were divided into NGT(1238) and IGR(802),then according to the different glycosuria hemoglobin levels,the IGR population were divided into HbA1c<5.7% group,5.7-6.0% group and >6.0% group.The age,FBG,2hPG,TG were significant positive correlation to different glycosuria hemoglobin levels(P<0.05).2.The accumulative total conversion rate to DM was[HbAlc>6.0%(33.3%)]>HbA1c5.7-6.0%(20.1%)>[HbA1c<5.7%(15.3%)] >NGT (6.1%).If the relative risk of NGT to DM was set to l,the risk of transferred to DM in HbAlc<5.7% group,5.7-6.0% group and >6.0% group were increased by 1.80 times,2.90 times,6.73 times.3.Multiple logistic regression analysis showed that age,FBG,2hPG and MAU were the leading risk factors of the different groups to DM.when the age, FBG,2hPQ MAU and other related factors were adjusted,a 1% increase in HbA1 would make the relative risk of diabetes increased by 1.70 times.Conclusions:HbAlc levels played an important role for the pre-diabetes transferred to DM,especially in the HbA1c>6.0% group.So individuals at high risk for developing diabetes (those with HbA1c> 6.0% of pre-diabetes populations) can be given interventions that significantly decrease the rate of onset of diabetes. |
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