Change in fasting plasma glucose and incident type 2 diabetes mellitus: results from a prospective cohort study.

ABSTRACT: OBJECTIVE:To investigate the association between changes in fasting plasma glucose (FPG) values and incident type 2 diabetes (T2D) in a cohort of the Iranian population. DESIGN:Prospective cohort study. SETTING:This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) to investigate the association between change in FPG between baseline examination (1999-2001) and the second visit (2002-2005) with incident T2D. PARTICIPANTS:A total of 3981 non-diabetic participants aged ?20?years. OUTCOME MEASURE:T2D was defined if the participant was using antidiabetic drugs or if FPG was ?7?mmol/L or if the 2?h post-challenge plasma glucose (2-hPCG) was ?11.1?mmol/L. RESULTS:During a median follow-up of 6.17?years, after the second examination, 288 new cases of T2D were identified. In a multivariate Cox proportional hazard analysis using age as timescale, we presented a simple model including FPG change (HR 1.19, 95% CI 1.07 to 1.33) and baseline waist circumference (WC) (HR 1.004, 95% CI 1.001 to 1.008) with a discriminative power (C-index) of 72%. Furthermore, we showed that the highest quartile of FPG change enhanced the T2D risk to 1.65 (95% CI 1.2 to 2.27) compared with the lowest quartile (p for trend=0.004).The independent risk of FPG change resisted further adjustment with 2-hPCG change. Adding the 2-hPCG change only slightly increased the discriminative power of the model including FPG change and baseline value of WC (0.73% vs 0.72%). After the study population had been limited to those with normal fasting glucose/normal glucose tolerance, FPG change remained an independent predictor (HR 1.57, 95% CI 1.31 to 1.88). CONCLUSIONS:Two measurements of FPG obtained about 3?years apart can help to identify populations at risk of incident T2D independently of important traditional risk factors and their changes, including 2-hPCG change.

SUBMITTER: Mozaffary A 

PROVIDER: S-EPMC4885425 | biostudies-literature |

REPOSITORIES: biostudies-literature