Open Access空腹血糖的就诊间变异对糖尿病发展的影响:胰岛素抵抗的介导作用
Author(s) -
Xu Jiji,
Li Ling,
Huang Shuangqing,
Song Haihong,
Gao Jinli,
Ni Hengru,
Lin Hong,
Wang Shuangyuan,
Li Mian,
Wang Tiange,
Zhao Zhiyun,
Xu Min,
Lu Jieli,
Bi Yufang,
Xu Yu,
Qian Xiaozhong
Publication year - 2022
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.13253
Subject(s) - medicine , diabetes mellitus , insulin resistance , confidence interval , odds ratio , glycemic , mediation , endocrinology , type 2 diabetes , plasma glucose , impaired fasting glucose , impaired glucose tolerance , political science , law
Background Little is known about the risk of diabetes due to higher glycemic variability and the underlying mechanisms. We aimed to examine the association of visit‐to‐visit variability (VVV) in fasting plasma glucose (FPG) with incident diabetes in Chinese adults and whether the association was mediated by changes in insulin resistance (IR). Methods We included 1856 community residents without a history of diabetes and having attended 3 examinations in 2008, 2009, and 2013 respectively. The SD, the average successive variability (ASV), the coefficient of variation (CV), and the variability independent of the mean (VIM) of three recorded FPG measurements were calculated for each participant, and SD, ASV, CV, and VIM were used as a measure of VVV in FPG. Incident diabetes was defined according to the 1999 World Health Organization criteria. IR was evaluated using the homeostatic model assessment (HOMA). Results A total of 153 (8.2%) participants developed incident diabetes at the third visit. Compared with the lowest tertile (0–5.83 mg/dl) of FPG‐SD, the highest tertile (9.55–74.17 mg/dl) was associated with a 148% increased risk of diabetes (odds ratio [OR], 2.48; 95% confidence interval [CI], 1.36–4.49), after adjustment for covariates including mean FPG at 3 visits. Mediation analyses suggested that changes in IR (ΔHOMA‐IR) might mediate 17.3% of the association between increased FPG‐SD and elevated diabetes risk. Similar results were found for FPG‐CV, FPG‐ASV, and FPG‐VIM. Conclusions The VVV in FPG was significantly associated with risks of diabetes in Chinese adults, which was partially mediated by changes in IR.