6-Year trajectory of fasting plasma glucose (FPG) and mortality risk among individuals with normal FPG at baseline: a prospective cohort study

Diabetology & Metabolic Syndrome

Research

Zecheng Zhu¹  Zhijun Ying¹  Yizhan Li¹  Huakang Tu¹  Sai Pan¹  Wenyuan Li¹  Wanlu Li¹  Min Yang²  Xifeng Wu³  Yi Guo⁴  Zhenya Song⁵  David Ta-Wei Chu⁶  Chi Pang Wen⁷ 

[1]Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

[2]Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

[3]Department of Nutrition and Food Hygiene School of Public Health, Zhejiang University School of Medicine, Hangzhou, China

[4]Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

[5]National Institute for Data Science in Health and Medicine, Zhejiang University, 866 Yuhangtang Road, 310058, Hangzhou, Zhejiang, China

[6]The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China

[7]Cancer Center, Zhejiang University, Hangzhou, Zhejiang, China

[8]School of Medicine and Health Science, George Washington University, Washington, DC, USA

[9]Department of Health Management Center and Department of General Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

[10]Department of Health Management Center and Department of General Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

[11]The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China

[12]MJ Health Management Center, Taipei, Taiwan

[13]National Institute for Data Science in Health and Medicine, Zhejiang University, 866 Yuhangtang Road, 310058, Hangzhou, Zhejiang, China

关键词: Fasting plasma glucose;    Mortality;    Epidemiology;    Longitudinal change;    Cohort analysis;    Glucose homeostasis;    Group-based trajectory model;   

DOI  :  10.1186/s13098-023-01146-2

 received in 2023-05-11, accepted in 2023-08-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundHigher fasting plasma glucose (FPG) levels were associated with an increased risk of all-cause mortality; however, the associations between long-term FPG trajectory groups and mortality were unclear, especially among individuals with a normal FPG level at the beginning. The aims of this study were to examine the associations of FPG trajectories with the risk of mortality and identify modifiable lifestyle factors related to these trajectories.MethodsWe enrolled 50,919 individuals aged ≥ 20 years old, who were free of diabetes at baseline, in the prospective MJ cohort. All participants completed at least four FPG measurements within 6 years after enrollment and were followed until December 2011. FPG trajectories were identified by group-based trajectory modeling. We used Cox proportional hazards models to examine the associations of FPG trajectories with mortality, adjusting for age, sex, marital status, education level, occupation, smoking, drinking, physical activity, body mass index, baseline FPG, hypertension, dyslipidemia, cardiovascular disease or stroke, and cancer. Associations between baseline lifestyle factors and FPG trajectories were evaluated using multinomial logistic regression.ResultsWe identified three FPG trajectories as stable (n = 32,481), low-increasing (n = 17,164), and high-increasing (n = 1274). Compared to the stable group, both the low-increasing and high-increasing groups had higher risks of all-cause mortality (hazard ratio (HR) = 1.18 (95% CI 0.99–1.40) and 1.52 (95% CI 1.09–2.13), respectively), especially among those with hypertension. Compared to participants with 0 to 1 healthy lifestyle factor, those with 6 healthy lifestyle factors were more likely to be in the stable group (ORlow-increasing = 0.61, 95% CI 0.51–0.73; ORhigh-increasing = 0.20, 95% CI 0.13–0.32).ConclusionsIndividuals with longitudinally increasing FPG had a higher risk of mortality even if they had a normal FPG at baseline. Adopting healthy lifestyles may prevent individuals from transitioning into increasing trajectories.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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Fig. 1