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Factors Associated With Progression to Pre-Diabetes: A Recurrent Events Analysis Publisher Pubmed



Mansourian M1 ; Yazdani A2 ; Faghihimani E3 ; Aminorraya A3 ; Amini M3 ; Jafarikoshki T4, 5
Authors
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Authors Affiliations
  1. 1. Department of Biostatistics and Epidemiology, Health School, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
  5. 5. Road Traffic Injury research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Attar-Neyshabouri St., Tabriz, Iran

Source: Eating and Weight Disorders Published:2020


Abstract

Aims: Pre-diabetes is a strong risk factor for type 2diabetes (T2D). The aim of this study was to explore factors associated with normal glucose maintenance and pre-diabetes prevention or delay. Methods: Data of 1016 first-degree relatives of T2D patients were retrieved from the Isfahan Diabetes Prevention Study (IDPS). Association of various variables including nutrients, serum tests and physical activity with the risk of pre-diabetes was assessed using recurrent events approach. Results: Cumulative incidence of diabetes was 8.17, 9.44, and 4.91% for total sample and individuals with and without pre-diabetes experience in the follow-up. Risk of progression to pre-diabetes was higher in women and older people (p < 0.01). Additionally, BMI and blood pressure had significant association with the risk (p < 0.01) and individuals with higher intake of fat were at higher risk (HR = 2.26; 95% CI 1.66–3.07 for high-intake and HR = 1.52; 95% CI 1.27–1.83 for medium-intake compared to low-intake group). Carbohydrates and protein intake were positively associated with the risk of pre-diabetes with HR = 8.63 per 49 g extra carbohydrates per day and HR = 1.32 per 6 g extra protein per day (p < 0.01). The association was also significant for triglyceride (TG) with 7% risk increase per 1 SD = 1.14 increase in TG level. Conclusion: Despite frequent studies on lifestyle modification for pre-diabetes prevention, less information is available about the role of nutritional components. We observed direct effects for intake of macronutrients including fat, carbohydrates, and protein in first-degree relatives. Further research is warranted to assess these associations in general populations. Level of evidence: Level III: Evidence obtained from a single-center cohort study. © 2018, Springer International Publishing AG, part of Springer Nature.
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