scholarly journals Not performing an OGTT results in underdiagnosis, inadequate risk assessment and probable cost increases of (pre)diabetes in Han Chinese over 40 years: a population-based prospective cohort study

2018 ◽  
Vol 7 (12) ◽  
pp. 1507-1517 ◽  
Author(s):  
Xiang Hu ◽  
Qiao Zhang ◽  
Tian-Shu Zeng ◽  
Jiao-Yue Zhang ◽  
Jie Min ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Cohort Study ◽  
Glucose Tolerance ◽  
Prospective Cohort Study ◽  
Plasma Glucose ◽  
Prospective Cohort ◽  
Population Based ◽  
Han Chinese ◽  
World Health ◽  
Over 40 Years

Objective To explore the influence by not performing an oral glucose tolerance test (OGTT) in Han Chinese over 40 years. Design Overall, 6682 participants were included in the prospective cohort study and were followed up for 3 years. Methods Fasting plasma glucose (FPG), 2-h post-load plasma glucose (2h-PG), FPG and 2h-PG (OGTT), and HbA1c testing using World Health Organization (WHO) or American Diabetes Association (ADA) criteria were employed for strategy analysis. Results The prevalence of diabetes is 12.4% (95% CI: 11.6–13.3), while the prevalence of prediabetes is 34.1% (95% CI: 32.9–35.3) and 56.5% (95% CI: 55.2–57.8) using WHO and ADA criteria, respectively. 2h-PG determined more diabetes individuals than FPG and HbA1c. The testing cost per true positive case of OGTT is close to FPG and less than 2h-PG or HbA1c. FPG, 2h-PG and HbA1c strategies would increase costs from complications for false-positive (FP) or false-negative (FN) results compared with OGTT. Moreover, the least individuals identified as normal by OGTT at baseline developed (pre)diabetes, and the most prediabetes individuals identified by HbA1c or FPG using ADA criteria developed diabetes. Conclusions The prevalence of isolated impaired glucose tolerance and isolated 2-h post-load diabetes were high, and the majority of individuals with (pre)diabetes were undetected in Chinese Han population. Not performing an OGTT results in underdiagnosis, inadequate developing risk assessment and probable cost increases of (pre)diabetes in Han Chinese over 40 years and great consideration should be given to OGTT in detecting (pre)diabetes in this population. Further population-based prospective cohort study of longer-term effects is necessary to investigate the risk assessment and cost of (pre)diabetes.

scholarly journals Risk of chronic kidney disease defined by decreased estimated glomerular filtration rate in individuals with different prediabetic phenotypes: results from a prospective cohort study in China

2020 ◽  
Vol 8 (1) ◽  
pp. e000955 ◽  
Author(s):  
Wei Li ◽  
Anping Wang ◽  
Jiajia Jiang ◽  
Guangxu Liu ◽  
Meiping Wang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Glucose Tolerance ◽  
Prospective Cohort Study ◽  
Glycemic Index ◽  
Plasma Glucose ◽  
Prospective Cohort ◽  
Population Attributable Risk ◽  
Increased Risk

ObjectiveWe aimed to investigate the effects of prediabetes and its phenotypes of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and elevated glycated hemoglobin A1c (EHbA1c) on chronic kidney disease (CKD) occurrence, and define the cut-off point of each glycemic index that significantly increases the risk of CKD.Research design and methodsIn this prospective cohort study, 6446 non-diabetic subjects aged 40 years and over were followed over a period of 3 years to track the new onset of CKD. Cox regression was used to assess the association of prediabetes and its phenotypes with CKD. Receiver operating characteristic curves were used to define the cut-off point of each glycemic index that significantly increases the occurrence of CKD. Population attributable risk percent was calculated to estimate the contribution of prediabetes to CKD.ResultsCompared to subjects with normal glucose tolerance, patients with prediabetes significantly increased the risk of development of CKD (HR=2.33 (1.19–4.55)). Specifically, this increased risk of CKD development was observed in patients with IFG, IGT and EHbA1c. The cut-off points shown to significantly increase the risk of CKD are fasting plasma glucose of 5.63 mmol/L, 2-hour plasma glucose of 6.80 mmol/L and HbA1c of 5.6%. The contribution of prediabetes to CKD occurrence in the study population was 60.6%.ConclusionsThis result suggests that the stricter criteria might be needed to define normal plasma glucose level in China that would not be predisposed to diabetic complications, particularly CKD.

scholarly journals Body composition and risk of gastric cancer: A population‐based prospective cohort study

2021 ◽  
Vol 10 (6) ◽  
pp. 2164-2174
Author(s):  
An‐Ran Liu ◽  
Qiang‐Sheng He ◽  
Wen‐Hui Wu ◽  
Jian‐Liang Du ◽  
Zi‐Chong Kuo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Body Composition ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Population Based

scholarly journals Long term prognostic implication of newly detected abnormal glucose tolerance among patients with stable cardiovascular disease: a population-based cohort study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Maryam Kabootari ◽  
Samaneh Asgari ◽  
Seyedeh Maryam Ghavam ◽  
Hengameh Abdi ◽  
Fereidoun Azizi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Glucose Tolerance ◽  
Plasma Glucose ◽  
Population Based ◽  
World Health ◽  
Incident Diabetes ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Diabetes Status ◽  
Adjusted Model

Abstract Background Fasting plasma glucose (FPG) and 2-h post challenge plasma glucose (2 h-PCPG), whether as continuous or categorical variables, are associated with incident cardiovascular disease (CVD) and diabetes; however, their role among patients with existing CVD is a matter of debate. We aimed to evaluate associations of different glucose intolerance states with recurrent CVD and incident diabetes among subjects with previous CVD. Methods From a prospective population-based cohort, 408 Iranians aged  ≥  30 years, with history of CVD and without known diabetes were included. Associations of impaired fasting glucose (IFG) according to the American Diabetes Association (ADA) and World Health Organization (WHO) criteria, impaired glucose tolerance (IGT), newly diagnosed diabetes (NDM) with outcomes of interest were determined by multivariable Cox proportional hazard models after adjustment for traditional risk factors. Furthermore, FPG and 2 h-PCPG were entered as continuous variables. Results Over a decade of follow-up, 220 CVD events including 89 hard events (death, myocardial infarction and stroke) occurred. Regarding prediabetes, only IFG-ADA was associated with increased risk of hard CVD [hazard ratio(HR), 95%CI: 1.62,1.03–2.57] in the age-sex adjusted model. In patients with NDM, those with FPG ≥ 7 mmol/L were at higher risk of incident CVD/coronary heart disease(CHD) and their related hard outcomes (HR ranged from 1.89 to 2.84, all P < 0.05). Moreover, those with 2 h-PCPG ≥ 11.1 mmol/L had significant higher risk of CVD (1.46,1.02–2.11), CHD (1.46,1.00–2.15) and hard CHD (1.95:0.99–3.85, P = 0.05). In the fully adjusted model, each 1 SD increase in FPG was associated with 20, 27, 15 and 25% higher risk of CVD, hard CVD, CHD and hard CHD, respectively; moreover each 1 SD higher 2 h-PCPG was associated with 21% and 16% higher risk of CVD, and CHD, respectively. Among individuals free of diabetes at baseline (n = 361), IFG-ADA, IFG-WHO and IGT were significantly associated with incident diabetes (all P < 0.05); significant associations were also found for FPG and 2 h-PCPG as continuous variables (all HRs for 1-SD increase > 2, P < 0.05). Conclusions Among subjects with stable CVD, NDM whether as high FPG or 2 h-PCPG, but not pre-diabetes status was significantly associated with CVD/CHD and related hard outcomes.

scholarly journals Mental Health Impact of the COVID-19 Pandemic in U.S. Military Veterans: A Population-Based, Prospective Cohort Study

2021 ◽  
pp. 1-37
Author(s):  
Melanie L. Hill ◽  
Brandon Nichter ◽  
Peter J. Na ◽  
Sonya B. Norman ◽  
Leslie A. Morland ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Military Veterans ◽  
Health Impact ◽  
Population Based

Higher Plasma Amyloid-β Levels Are Associated with a Higher Risk of Cancer: A Population-Based Prospective Cohort Study

2020 ◽  
Vol 29 (10) ◽  
pp. 1993-2001
Author(s):  
Kimberly D. van der Willik ◽  
Mohsen Ghanbari ◽  
Lana Fani ◽  
Annette Compter ◽  
Rikje Ruiter ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Amyloid Β ◽  
Population Based ◽  
Risk Of Cancer

scholarly journals Are people with metabolically healthy obesity really healthy? A prospective cohort study of 381,363 UK Biobank participants

Diabetologia ◽  
2021 ◽  
Author(s):  
Ziyi Zhou ◽  
John Macpherson ◽  
Stuart R. Gray ◽  
Jason M. R. Gill ◽  
Paul Welsh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Respiratory Diseases ◽  
Population Based ◽  
Incident Diabetes ◽  
Uk Biobank ◽  
Metabolically Healthy Obesity ◽  
Wide Range ◽  
Metabolically Healthy

Abstract Aims/hypothesis People with obesity and a normal metabolic profile are sometimes referred to as having ‘metabolically healthy obesity’ (MHO). However, whether this group of individuals are actually ‘healthy’ is uncertain. This study aims to examine the associations of MHO with a wide range of obesity-related outcomes. Methods This is a population-based prospective cohort study of 381,363 UK Biobank participants with a median follow-up of 11.2 years. MHO was defined as having a BMI ≥ 30 kg/m2 and at least four of the six metabolically healthy criteria. Outcomes included incident diabetes and incident and fatal atherosclerotic CVD (ASCVD), heart failure (HF) and respiratory diseases. Results Compared with people who were not obese at baseline, those with MHO had higher incident HF (HR 1.60; 95% CI 1.45, 1.75) and respiratory disease (HR 1.20; 95% CI 1.16, 1.25) rates, but not higher ASCVD. The associations of MHO were generally weaker for fatal outcomes and only significant for all-cause (HR 1.12; 95% CI 1.04, 1.21) and HF mortality rates (HR 1.44; 95% CI 1.09, 1.89). However, when compared with people who were metabolically healthy without obesity, participants with MHO had higher rates of incident diabetes (HR 4.32; 95% CI 3.83, 4.89), ASCVD (HR 1.18; 95% CI 1.10, 1.27), HF (HR 1.76; 95% CI 1.61, 1.92), respiratory diseases (HR 1.28; 95% CI 1.24, 1.33) and all-cause mortality (HR 1.22; 95% CI 1.14, 1.31). The results with a 5 year landmark analysis were similar. Conclusions/interpretation Weight management should be recommended to all people with obesity, irrespective of their metabolic status, to lower risk of diabetes, ASCVD, HF and respiratory diseases. The term ‘MHO’ should be avoided as it is misleading and different strategies for risk stratification should be explored. Graphical abstract

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