Abdominal aorta diameter as a novel marker of diabetes incidence risk in elderly women

Abstract

the prevalence of diabetes mellitus is increasing worldwide, including the nation of poland. the aim of this prospective and observational study was to determine risk factors and the predictors of diabetes incidence in elderly women, and to calculate the diabetes incidence ratio in this population. Two-hundred women, aged 65-74, who were non-diabetic at baseline in 2012 were followed for 6.5 years. All women were checked for incident diabetes. In non-diabetic subjects, diagnostic procedures for diabetes were performed according to poland's Diabetes recommendations. Between April 2012 and September 2018, 25 women developed diabetes and the next 11 cases were diagnosed based on FPG or oral glucose tolerance test. Women with incident diabetes had significantly higher baseline FPG, triglycerides (TG), TG/HDL cholesterol ratio and visceral adiposity index (VAI) score, and lower abdominal aorta diameter (AAD), HDL cholesterol and eGFR. In the Cox proportional hazard regression analysis, only AAD < 18 mm and VAI score ≥ 3.8 were independently associated with diabetes risk, hazard ratio (HR) 2.47 (95% confidence interval 1.21-5.02), P = 0.013 and HR 2.83 (1.35-5.94), P = 0.006 respectively. In the backward stepwise regression analysis including all variables, diabetes incidence could be predicted from a linear combination of the independent variables: AAD < 18 mm (P = 0.002), VAI score ≥ 3.8 (P < 0.001) and FPG ≥ 5.6 mmol/L (P = 0.011). The calculated incidence of diabetes was 2769.2 new cases/100,000 persons per year. AAD below 18 mm seem to be a novel, independent marker of diabetes risk in elderly women, and AAD assessment during routine abdomen ultrasound may be helpful in identifying females at early elderliness with high risk of diabetes incidence. The rising tide of diabetes mellitus prevalence and incidence is being observed worldwide with 463 million people suffering from diabetes in the year 2019 1. The same trend has also been observed in Poland. In the year 2014, 2.34 million people (6.08% of the total population) were treated with antidiabetic medications 2. Type 2 diabetes is especially highly prevalent among people aged over 65 and roughly one third of all cases are diagnosed in this age range 1,3. In SouthEastern Poland, its prevalence in 2018 among people aged over 65 reached 26% of population in this age range (data on request from National Health Fund, unpublished). According to data published by the National Health Fund and Central Statistical Office, diabetes incidence in the Kuyavian-Pomeranian Voivodeship (central Poland) in women aged > 65 was 1860.7 new cases per 100,000 persons per year, consisting 45.6% of all new cases of diabetes in 2016 4. Established risk factors of diabetes incidence include: family history of diabetes, increased BMI, abdominal obesity, low physical activity, hypertension, impaired glucose metabolism in the past, high-risk race/ethnicity, elevated triglycerides (TG) and/or low HDL cholesterol level, and, among women, delivering children with birth weight over 4000 g, a his...

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