Determinants of the progression to type 2 diabetes and regression to normoglycemia in people with pre-diabetes: A population‐based cohort study over ten years

Kohansal, Karim; Ahmadi, Nooshin; Hadaegh, Farzad; Alizadeh, Zeinab; Azizi, Fereidoun; Habibi-Moeini, Ali Siamak; Khalili, Davood

doi:10.1016/j.pcd.2022.10.002

Cited by 3 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results showed that, in the negative correlation between AIP and the reversal of prediabetes, the point estimate of the E-value was 1.50. Comparing this with previously published results on factors reversing prediabetes [ 46 – 48 ], it seems unlikely that any unmeasured confounding factors would significantly affect the stability of our results. Moreover, in the positive correlation between AIP and the progression of prediabetes, the point estimate of the E-value was 2.19.…”

Section: Resultssupporting

confidence: 85%

Evaluation of the role of atherogenic index of plasma in the reversion from Prediabetes to normoglycemia or progression to Diabetes: a multi-center retrospective cohort study

Yang,

Kuang,

Yang

et al. 2024

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background Atherosclerosis is closely linked with glucose metabolism. We aimed to investigate the role of the atherogenic index of plasma (AIP) in the reversal of prediabetes to normal blood glucose levels or its progression to diabetes. Methods This multi-center retrospective cohort study included 15,421 prediabetic participants from 32 regions across 11 cities in China, under the aegis of the Rich Healthcare Group’s affiliated medical examination institutions. Throughout the follow-up period, we monitored changes in the glycemic status of these participants, including reversal to normal fasting glucose (NFG), persistence in the prediabetic state, or progression to diabetes. Segmented regression, stratified analysis, and restricted cubic spline (RCS) were performed based on the multivariable Cox regression model to evaluate the association between AIP and the reversal of prediabetes to NFG or progression to diabetes. Results During a median follow-up period of 2.9 years, we recorded 6,481 individuals (42.03%) reverting from prediabetes to NFG, and 2,424 individuals (15.72%) progressing to diabetes. After adjusting for confounders, AIP showed a positive correlation with the progression from prediabetes to diabetes [(Hazard ratio (HR) 1.42, 95% confidence interval (CI):1.24–1.64)] and a negative correlation with the reversion from prediabetes to NFG (HR 0.89, 95%CI:0.81–0.98); further RCS demonstrated a nonlinear relationship between AIP and the reversion from prediabetes to NFG/progression to diabetes, identifying a turning point of 0.04 for reversion to NFG and 0.17 for progression to diabetes. In addition, we observed significant differences in the association between AIP and reversion from prediabetes to NFG/progression to diabetes across age subgroups, specifically indicating that the risk associated with AIP for progression from prediabetes to diabetes was relatively higher in younger populations; likewise, a younger age within the adult group favored the reversion from prediabetes to NFG in relation to AIP. Conclusion Our study, for the first time, reveals a negative correlation between AIP and the reversion from prediabetes to normoglycemia and validates the crucial role of AIP in the risk assessment of prediabetes progression. Based on threshold analysis, therapeutically, keeping the AIP below 0.04 was of paramount importance for individuals with prediabetes aiming for reversion to NFG; preventatively, maintaining AIP below 0.17 was vital to reduce the risk of diabetes onset for those with prediabetes.

show abstract

Section: Resultssupporting

confidence: 85%

Evaluation of the role of atherogenic index of plasma in the reversion from Prediabetes to normoglycemia or progression to Diabetes: a multi-center retrospective cohort study

Yang,

Kuang,

Yang

et al. 2024

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…A study with a limited sample size from a German national cohort identified female and elevated HDL-C levels as determinants for the reversion from Pre-DM to normoglycemia 20 . Similarly, another cohort research with a slightly larger sample size demonstrated a positive connection between heightened HDL-C levels and the probability of the reversion from Pre-DM to normoglycemia 21 . Regrettably, prior investigations concerning the connection between HDL-C levels and the reversion from Pre-DM to normoglycemia lacked subgroup analyses or examination of the non-linear connection between these variables.…”

Section: Introductionmentioning

confidence: 84%

“…In order to ascertain the dependability of the results, a sequence of sensitivity analyses was conducted. Prior research has indicated a significant association between BMI and age with the reversion from Pre-DM to normoglycemia 21 , 27 . A sensitivity analysis was conducted on subjects with a BMI < 25 kg/m 2 .…”

Section: Discussionmentioning

confidence: 99%

“…Regrettably, there is a lack of literature exploring the interrelation between them. In a longitudinal study comprising 1329 individuals diagnosed with prediabetes, the findings of a Cox proportional hazards multivariate model indicated that a 1 mmol/L elevation in HDL-C levels was linked to a 70% increase in the likelihood of achieving normoglycemia among subjects with Pre-DM (HR: 1.70, 95% CI: 1.23–2.34) 21 . Another investigation involving 817 individuals diagnosed with prediabetes from Germany has demonstrated that for every 10 mg/dL increase in HDL-C levels, there was a 17% higher probability of attaining normoglycemia in patients with prediabetes after controlling for residential traffic intensity, mental distress, age, lifestyle factors, educational level, anthropometric markers, and sex (HR 1.17, 95% CI 1.02–1.35) 20 .…”

Section: Discussionmentioning

confidence: 99%

“…Compared to those on the left side of the inflection point, participants on the right side tend to be older, with higher TC, LDL-C, and BUN levels and a higher proportion of current drinkers (Table S2 A and Table S2 B). Previous studies have indicated that these covariates inhibit the reversion of normoglycemia from prediabetes 18 , 21 , 46 . Therefore, we speculate that once HDL-C exceeds the inflection point, its role in promoting the reversion to normoglycemia from prediabetes might be weakened due to the influence of age, TC, LDL-C, BUN, and alcohol consumption.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Association between high-density lipoprotein cholesterol and reversion to normoglycemia from prediabetes: an analysis based on data from a retrospective cohort study

Mo,

Hu,

Han

et al. 2024

Sci Rep

View full text Add to dashboard Cite

The available evidence on the connection between high-density lipoprotein cholesterol (HDL-C) levels and the reversion from prediabetes (Pre-DM) to normoglycemia is currently limited. The present research sought to examine the connection between HDL-C levels and the regression from Pre-DM to normoglycemia in a population of Chinese adults. This historical cohort study collected 15,420 Pre-DM patients in China who underwent health screening between 2010 and 2016. The present research used the Cox proportional hazards regression model to investigate the connection between HDL-C levels and reversion from Pre-DM to normoglycemia. The Cox proportional hazards regression model with cubic spline functions and smooth curve fitting was employed to ascertain the nonlinear association between HDL-C and reversion from Pre-DM to normoglycemia. Furthermore, a set of sensitivity analyses and subgroup analyses were employed. Following the adjustment of covariates, the findings revealed a positive connection between HDL-C levels and the likelihood of reversion from Pre-DM to normoglycemia (HR 1.898, 95% CI 1.758–2.048, P < 0.001). Furthermore, there was a non-linear relationship between HDL-C and the reversion from Pre-DM to normoglycemia in both genders, and the inflection point of HDL-C was 1.540 mmol/L in males and 1.620 mmol/L in females. We found a strong positive correlation between HDL-C and the reversion from Pre-DM to normoglycemia on the left of the inflection point (Male: HR 2.783, 95% CI 2.373–3.263; Female: HR 2.217, 95% CI 1.802–2.727). Our sensitivity analysis confirmed the robustness of these findings. Subgroup analyses indicated that patients with SBP < 140 mmHg and ever smoker exhibited a more pronounced correlation between HDL-C levels and the reversion from Pre-DM to normoglycemia. In contrast, a less robust correlation was observed among patients with SBP ≥ 140 mmHg, current and never smokers. This study provides evidence of a positive and nonlinear association between HDL-C levels and the reversion from Pre-DM to normoglycemia in Chinese patients. Implementing intensified intervention measures to control the HDL-C levels of patients with Pre-DM around the inflection point may substantially enhance the likelihood of regression to normoglycemia.

show abstract

Progression to diabetes and regression to normoglycemia in pre-diabetic subjects: results from a pragmatic community trial in a middle-income country

Khalili,

Dehghani,

Asgari

et al. 2024

J Diabetes Metab Disord

View full text Add to dashboard Cite

Determinants of the progression to type 2 diabetes and regression to normoglycemia in people with pre-diabetes: A population‐based cohort study over ten years

Cited by 3 publications

References 25 publications

Evaluation of the role of atherogenic index of plasma in the reversion from Prediabetes to normoglycemia or progression to Diabetes: a multi-center retrospective cohort study

Evaluation of the role of atherogenic index of plasma in the reversion from Prediabetes to normoglycemia or progression to Diabetes: a multi-center retrospective cohort study

Association between high-density lipoprotein cholesterol and reversion to normoglycemia from prediabetes: an analysis based on data from a retrospective cohort study

Progression to diabetes and regression to normoglycemia in pre-diabetic subjects: results from a pragmatic community trial in a middle-income country

Contact Info

Product

Resources

About